Provider Demographics
NPI:1104182625
Name:NET WORTH RECOVERY
Entity Type:Organization
Organization Name:NET WORTH RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-260-9305
Mailing Address - Street 1:4320 STEVENS CREEK BLVD
Mailing Address - Street 2:STE 220
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-1202
Mailing Address - Country:US
Mailing Address - Phone:408-260-9305
Mailing Address - Fax:408-260-9305
Practice Address - Street 1:4320 STEVENS CREEK BLVD
Practice Address - Street 2:STE 220
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-1202
Practice Address - Country:US
Practice Address - Phone:408-260-9305
Practice Address - Fax:408-260-9305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 18214251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health