Organization
WINDWARD WAY RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IAN ROY (BILLING DIRECTOR)
(657) 304-0103
Entity
Organization
Contact information
Practice address
2137 DOCTORS CIR UNIT B, COSTA MESA, CA 92627-1969
(657) 304-0103
Mailing address
3822 CAMPUS DR STE 500, NEWPORT BEACH, CA 92660-2607
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300246GP
DHCS
CA
Enumeration date
10/05/2018
Last updated
05/07/2020
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