Organization
THE GATES RECOVERY FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
APRIL J ANTONIOU (CREDENTIALING SERVICES MANAGER)
(805) 413-1318
Entity
Organization
Contact information
Practice address
2810 COLOMA ST, PLACERVILLE, CA 95667-4406
(530) 622-9500
(530) 622-9534
Mailing address
3717 E THOUSAND OAKS BLVD, SUITE 266, WESTLAKE VILLAGE, CA 91362-3607
(805) 413-1318
(805) 413-1304
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
090016AN
CA
Other
Enumeration date
01/26/2007
Last updated
08/22/2020
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