Organization
CITY RECOVERY INTENSIVE OUTPATIENT PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMAN ELEY (CHIEF OF OPERATIONS)
(714) 225-5994
Entity
Organization
Contact information
Practice address
1100 W TOWN AND COUNTRY RD STE 1208, ORANGE, CA 92868-4600
(714) 225-5994
Mailing address
9592 PERIDOT AVE, HESPERIA, CA 92344-8099
(714) 225-5994
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
12/18/2019
Last updated
12/20/2019
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