Organization
BLUESTONE RECOVERY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J LYONS LAADAC (CEO)
(951) 536-2213
Entity
Organization
Contact information
Practice address
1660 CHICAGO AVE STE M11, RIVERSIDE, CA 92507-2033
(951) 823-0540
(951) 823-0541
Mailing address
1660 CHICAGO AVE STE M11, RIVERSIDE, CA 92507-2033
(951) 823-0540
(951) 823-0541
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
330127AP
CA
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
330127AP
CA
324500000X
Substance Abuse Rehabilitation Facility
360107BP
CA
Other
Enumeration date
08/20/2014
Last updated
09/20/2016
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