Provider Demographics
NPI:1043981681
Name:LIVING STONES RECOVERY LLC
Entity Type:Organization
Organization Name:LIVING STONES RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:LIVINGSTONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-271-2455
Mailing Address - Street 1:22370 RAMONA AVE
Mailing Address - Street 2:
Mailing Address - City:NUEVO
Mailing Address - State:CA
Mailing Address - Zip Code:92567
Mailing Address - Country:US
Mailing Address - Phone:714-271-2455
Mailing Address - Fax:
Practice Address - Street 1:22675 HILLS RANCH ROAD
Practice Address - Street 2:
Practice Address - City:NUEVO
Practice Address - State:CA
Practice Address - Zip Code:92567
Practice Address - Country:US
Practice Address - Phone:951-818-4458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder