Provider Demographics
NPI:1043753171
Name:STEPHOUSE RECOVERY
Entity Type:Organization
Organization Name:STEPHOUSE RECOVERY
Other - Org Name:ALL ABOUT SOBRIETY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:VILAGUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-933-6652
Mailing Address - Street 1:19744 BEACH BLVD # 141
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-2988
Mailing Address - Country:US
Mailing Address - Phone:714-933-6652
Mailing Address - Fax:
Practice Address - Street 1:19744 BEACH BLVD # 141
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-2988
Practice Address - Country:US
Practice Address - Phone:714-933-6652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility