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Organization

LIFE HOUSE RECOVERY HOMES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. TARA NICOLE WHITAKER (OFFICE MANAGER)
(510) 999-7901
Entity
Organization

Contact information

Practice address
22280 MAIN ST, HAYWARD, CA 94541-4005
(510) 999-7901
(510) 315-1231
Mailing address
22280 MAIN ST, HAYWARD, CA 94541-4005
(510) 999-7901
(510) 315-1231

Taxonomy

Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary

Other

Enumeration date
03/25/2021
Last updated
03/25/2021
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