Organization
CHILDREN'S RECOVERY CENTER, I LLC
Active
Other names
Children's Recovery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH SHAWN MCGUIRE (PRESIDENT/CEO)
(408) 340-1568
Entity
Organization
Contact information
Practice address
3777 S. BASCOM AVE, CAMPBELL, CA 95008
(408) 558-3640
(408) 377-1139
Mailing address
3777 S. BASCOM AVENUE, CAMPBELL, CA 95008
(408) 358-3640
(408) 377-1139
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
070000320
CA
283XC2000X
Children's Rehabilitation Hospital
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Other
Enumeration date
02/22/2007
Last updated
03/09/2017
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