Provider Demographics
NPI:1033644331
Name:GOLD STANDARD RECOVERY SERVICES, LLC
Entity Type:Organization
Organization Name:GOLD STANDARD RECOVERY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CHELCIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:GUTHRIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:657-464-0322
Mailing Address - Street 1:2319 WHITESANDS DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-2855
Mailing Address - Country:US
Mailing Address - Phone:310-437-3114
Mailing Address - Fax:
Practice Address - Street 1:2319 WHITESANDS DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-2855
Practice Address - Country:US
Practice Address - Phone:310-437-3114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-24
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
324500000X
CA300009AP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility