Organization
ABLE TO CHANGE RECOVERY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARALYN COHEN (CEO)
(949) 493-6800
Entity
Organization
Contact information
Practice address
23492 WHITE DOVE DR, LAKE FOREST, CA 92630-3765
(949) 493-6800
(949) 493-6832
Mailing address
31501 RANCHO VIEJO RD, STE. 101, SAN JUAN CAPISTRANO, CA 92675-1869
(949) 493-6800
(949) 493-6832
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
300118CP
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005693
BLUE CROSS MED ID#
CA
01
—
300118CP
CA DEPT ALCOHOL DRUG PROGRAMS
CA
Enumeration date
04/05/2011
Last updated
07/26/2019
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