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FIRST LIGHT RECOVERY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MELODY JOY STONE LMFT (PROGRAM DIRECTOR)
(949) 294-5104
Entity
Organization

Contact information

Practice address
140 AVENIDA ALGODON, SAN CLEMENTE, CA 92627
(949) 294-5104
Mailing address
140 AVENIDA ALGODON, SAN CLEMENTE, CA 92672-4182

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
300325AP
CA

Other

Enumeration date
09/15/2015
Last updated
09/15/2015
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