Organization
MOONSTONE RECOVERY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN RYAN FAILLE (PRESIDENT)
(619) 456-7337
Entity
Organization
Contact information
Practice address
845 HENNESSEY WAY, PLUMAS LAKE, CA 95961-9224
(619) 456-7337
Mailing address
845 HENNESSEY WAY, PLUMAS LAKE, CA 95961-9224
(619) 456-7337
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
03/19/2024
Last updated
03/19/2024
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