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Organization

CANYON CREST RECOVERY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TIMOTHY MEISE (OWNER)
(609) 342-9430
Entity
Organization

Contact information

Practice address
19238 ARMINTA ST, RESEDA, CA 91335-1107
(781) 964-2691
Mailing address
11530 VENEZIA WAY, PORTER RANCH, CA 91326-4404

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary

Other

Enumeration date
04/14/2025
Last updated
04/14/2025
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