Organization
RISING ROADS RECOVERY SERVICES FOR WOMEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA A GATDULA (CEO)
(714) 673-9007
Entity
Organization
Contact information
Practice address
3151 AIRWAY AVE STE I3, COSTA MESA, CA 92626-4624
(949) 922-1901
Mailing address
24072 PARKHILL RD, LAKE FOREST, CA 92630-3727
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
300659BP
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3000659BP
PPO
CA
Enumeration date
10/04/2017
Last updated
03/05/2024
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