Grand Terrace Detox And Recovery

LBN: Grand Terrace Detox And Recovery
Grand Terrace Detox And Recovery is an health care organization with primary practice located at 18989 Grand Ave , Lake Elsinore CA 92530-6259. The organization recently has only one registered license in Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, which is considered as the primary health care specialty. Grand Terrace Detox And Recovery can be contacted via phone (954) 210-8617, or through Mccoy, Eric via phone (954) 446-3538.

Contact Information

Primary practice address
18989 Grand Ave Lake Elsinore CA 92530-6259
Fax: (954) 982-2827
Website:
Authorized official contact:
Name: Mccoy, Eric

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X 330168AP California

Profile Details

NPI number 1154847838
LBN Legal business name Grand Terrace Detox And Recovery
DBA Doing business as
Authorized official Mccoy, Eric
Entity Organization
Organization subpart 1 No
Enumeration date Aug 15th, 2017
Last updated Jul 21st, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154847838 NPPES
California Other 330168AP LICENSE AND CERTIFICATION

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