Organization
GRANT ME THE COURAGE RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA BAUTISTA (CFO)
(714) 262-9521
Entity
Organization
Contact information
Practice address
3350 E BIRCH ST STE 101, BREA, CA 92821-6266
(877) 290-2058
(866) 659-9110
Mailing address
3350 E BIRCH ST STE 101, BREA, CA 92821-6266
(877) 290-2058
(866) 659-9110
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
06/04/2013
Last updated
07/13/2022
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