Organization
FREE AT LAST:COMMUNITY RECOVERY AND REHABILITATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH MENDOZA (ADMINISTRATOR)
(650) 462-6999
Entity
Organization
Contact information
Practice address
1796 BAY RD, EAST PALO ALTO, CA 94303-1611
(650) 462-6999
(650) 462-1055
Mailing address
1796 BAY RD, EAST PALO ALTO, CA 94303-1611
(650) 462-6999
(650) 462-1055
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
410027IN
CA
324500000X
Substance Abuse Rehabilitation Facility
410027AN
CA
324500000X
Substance Abuse Rehabilitation Facility
410027BN
CA
324500000X
Substance Abuse Rehabilitation Facility
410027LN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FREEATLAST11
—
CA
Enumeration date
06/16/2011
Last updated
06/16/2011
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