Organization
GLORIOSA MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHLOAS RUSSI LAADC,NCAC,CCS (ADMINISTRATOR AND DIRECTOR)
(951) 427-4807
Entity
Organization
Contact information
Practice address
25466 GLORIOSA DR, MISSION VIEJO, CA 92691-4642
(951) 427-4807
Mailing address
28202 CABOT RD, 300, LAGUNA NIGUEL, CA 92677-1222
(951) 427-4807
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/26/2015
Last updated
06/26/2015
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