Organization
NEW ROUTE RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH DESIDERIO (MGR)
(424) 478-1336
Entity
Organization
Contact information
Practice address
3215 BONNIE HILL DR, LOS ANGELES, CA 90068-1322
(424) 478-1336
(213) 995-8716
Mailing address
1968 S COAST HWY STE 2839, LAGUNA BEACH, CA 92651-3681
(424) 478-1336
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
305R00000X
Preferred Provider Organization
—
—
Other
Enumeration date
06/05/2023
Last updated
06/16/2023
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