Organization
THE HOUSE OF THE RISING SON
Active
Other names
THORS Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE F BAHU (OWNER/CFO)
(503) 793-8919
Entity
Organization
Contact information
Practice address
521 W AVENIDA DE LOS LOBOS MARINOS, SAN CLEMENTE, CA 92672-4374
(503) 793-8919
Mailing address
521 W AVENIDA DE LOS LOBOS MARINOS, SAN CLEMENTE, CA 92672-4374
(503) 793-8919
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
300633AP
CA
Other
Enumeration date
06/01/2016
Last updated
06/01/2016
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