Organization
IMAGINE RECOVERY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALTER YBARRA (CEO)
(714) 312-0165
Entity
Organization
Contact information
Practice address
1247 N LAKEVIEW AVE STE A, ANAHEIM, CA 92807-1833
(714) 312-0165
(714) 970-9779
Mailing address
1247 N LAKEVIEW AVE STE A, ANAHEIM, CA 92807-1833
(714) 312-0165
(714) 970-9779
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/22/2018
Last updated
10/22/2018
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