Organization
CREST RECOVERY LLC
Active
Other names
TruVida Recovery
Organization subpart
No
Provider details
NPI number
Authorized official
CEAIRA COFFIN (BILLING DIRECTOR)
(833) 233-0091
Entity
Organization
Contact information
Practice address
26202 BUENA VISTA CT, LAGUNA HILLS, CA 92653-5620
(949) 283-4679
Mailing address
23726 BIRTCHER DR, LAKE FOREST, CA 92630-1771
(949) 283-4679
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300351CP
DHCS
CA
Enumeration date
10/03/2018
Last updated
04/08/2020
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