Organization
CENTRAL CALIFORNIA RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE DEAN WHITE CADC (EXECUTIVE DIRECTOR)
(559) 681-1947
Entity
Organization
Contact information
Practice address
1204 W SHAW AVE #102, FRESNO, CA 93711-3706
(559) 681-1947
(559) 860-0130
Mailing address
1204 W SHAW AVE #102, FRESNO, CA 93711-3706
(559) 681-1947
(559) 860-0130
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106364
—
CA
Enumeration date
01/09/2009
Last updated
05/23/2019
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