Provider Demographics
NPI:1134510290
Name:CALIFORNIA ADDICTION TREATMENT CENTER LLC
Entity Type:Organization
Organization Name:CALIFORNIA ADDICTION TREATMENT CENTER LLC
Other - Org Name:CALIFORNIA HIGHLANDS ADDICTION TREATMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BORKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-487-1224
Mailing Address - Street 1:300 S HIGHLAND SPRINGS AVE
Mailing Address - Street 2:SUITE 6C #185
Mailing Address - City:BANNING
Mailing Address - State:CA
Mailing Address - Zip Code:92220-6504
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15986 HIGHLAND SPRINGS AVENUE
Practice Address - Street 2:
Practice Address - City:BANNING
Practice Address - State:CA
Practice Address - Zip Code:92220-6508
Practice Address - Country:US
Practice Address - Phone:951-972-2023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility