Organization
HOWER LODGE, INC.
Active
Other names
Hope Lodge
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER GATES (CCO / MANAGING MEMBER)
(949) 701-1959
Entity
Organization
Contact information
Practice address
26166 CIRCLE DRIVE, LAKE ARROWHEAD, CA 92352
(909) 338-3851
Mailing address
33171 PASEO CERVEZA, SAN JUAN CAPISTRANO, CA 92675-4824
(949) 701-1959
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
360113AP
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300733AP
DHCS: DETOX, IMS, & RECOVERY/TREATMENT SERVICES
CA
01
—
360113AP
DHCS: DETOX, IMS & RECOVERY/TREATMENT SERVICES LICENSE
CA
01
—
620869
THE JOINT COMMISSION
CA
Enumeration date
08/01/2017
Last updated
11/01/2023
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