Organization
EXECUTIVE RECOVERY GROUP, INC
Active
Parent organization
EXECUTIVE RECOVERY GROUP, INC
Other names
The Lake, Phoenix Rising Recovery, Phoenix Rising Recovery IOP
Organization subpart
Yes
Provider details
NPI number
Legal business name
EXECUTIVE RECOVERY GROUP, INC
Authorized official
AMY CRICHTON (EXECUTIVE DIRECTOR)
(760) 200-3839
Entity
Organization
Contact information
Practice address
77725 ENFIELD LN # 100-200, PALM DESERT, CA 92211
(760) 345-7239
Mailing address
77725 ENFIELD LN, PALM DESERT, CA 92211-0468
(760) 409-1287
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
330143BP
CA
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
330143BP
CA
Other
Enumeration date
03/05/2018
Last updated
08/07/2018
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