Organization
EAGLE CREEK RANCH RECOVERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW JOHN MALOOF (CEO)
(949) 682-6560
Entity
Organization
Contact information
Practice address
6770 ELM LN, NAMPA, ID 83687-8124
(949) 682-6560
Mailing address
6770 ELM LN, NAMPA, ID 83687-8124
(949) 682-6560
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
08/11/2022
Last updated
08/22/2022
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