Organization
FIDARE HEALTH CO
Active
Other names
COASTAL RECOVERY CONCEPTS
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHON WHEATON (AUTHORIZED OFFICER)
(619) 782-0011
Entity
Organization
Contact information
Practice address
3434 GROVE ST, LEMON GROVE, CA 91945-1812
(619) 782-0011
Mailing address
2358 UNIVERSITY AVE STE 371, SAN DIEGO, CA 92104-2720
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
01/27/2025
Last updated
01/27/2025
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