Organization
LA JOLLA RECOVERY INC
Active
Parent organization
LA JOLLA RECOVERY
Organization subpart
Yes
Provider details
NPI number
Legal business name
LA JOLLA RECOVERY
Authorized official
DANIEL SIMONS (CEO)
(858) 877-3422
Entity
Organization
Contact information
Practice address
1446, 1448 & 1450 DIAMOND ST, SAN DIEGO, CA 92109-3023
(858) 877-3422
Mailing address
1804 GARNET AVE # 233, SAN DIEGO, CA 92109-3352
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
370159DP
DHCS
CA
Enumeration date
02/24/2021
Last updated
02/24/2021
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