Organization
CHANGES FOR RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MILTON MUCKER CADC II (OWNER/PROGRAM DIRECTOR)
(714) 541-4007
Entity
Organization
Contact information
Practice address
300 N TUSTIN AVE, SUITE 201, SANTA ANA, CA 92705-3820
(714) 541-4007
(714) 541-2770
Mailing address
300 N TUSTIN AVE, SUITE 201, SANTA ANA, CA 92705-3820
(714) 541-4007
(714) 541-2770
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
300097BP
CA
Other
Enumeration date
10/16/2006
Last updated
08/22/2020
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