Organization
HOPE CANYON
Active
Other names
Hope Canyon
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT NIZNIK (CEO)
(855) 804-6503
Entity
Organization
Contact information
Practice address
2821 LANGE AVE, SAN DIEGO, CA 92122-3109
(855) 804-6503
Mailing address
1515 NW 167TH ST STE 300, MIAMI GARDENS, FL 33169-5106
(786) 923-3376
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
CA
Other
Enumeration date
10/17/2017
Last updated
06/04/2020
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