Provider Demographics
NPI:1093130601
Name:HEALING PATH RECOVERY A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:HEALING PATH RECOVERY A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:BEHESHTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-929-7956
Mailing Address - Street 1:366 SAN MIGUEL DR STE 310
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7810
Mailing Address - Country:US
Mailing Address - Phone:949-706-5215
Mailing Address - Fax:
Practice Address - Street 1:366 SAN MIGUEL DR STE 310
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7810
Practice Address - Country:US
Practice Address - Phone:949-706-5215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility