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Organization

DR RECOVERY ENCINITAS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. NATE IZZO (OFFICE MANAGER)
(949) 419-4929
Entity
Organization

Contact information

Practice address
609 S. VULCAN AVE STE 301, ENCINITAS, CA 92024
(949) 419-4929
(949) 484-7021
Mailing address
609 S VULCAN AVE STE 301, ENCINITAS, CA 92024-3600
(949) 419-4929
(949) 542-3878

Taxonomy

Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
370143AP
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05D2083893
CLIA
CA
01
370143AP
DEPARTMENT OF HEALTHCARE SERVICES DHHS
CA
Enumeration date
01/20/2015
Last updated
03/19/2019
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