Organization
RANCH CREEK RECOVERY,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY TICHELAAR (PRESIDENT)
(714) 396-5413
Entity
Organization
Contact information
Practice address
43264 BUSINESS PARK DR STE 101, TEMECULA, CA 92590-3646
(951) 696-9200
(951) 695-9366
Mailing address
27636 YNEZ RD # 271, TEMECULA, CA 92591-5600
(714) 396-5413
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538459060
NPI NUMBER
—
Enumeration date
02/26/2020
Last updated
02/26/2020
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