Provider Demographics
NPI:1164559076
Name:RICKMAN RECOVERY CENTERS
Entity Type:Organization
Organization Name:RICKMAN RECOVERY CENTERS
Other - Org Name:RICKMANRECOVERY CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:RICKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:BA,RAS
Authorized Official - Phone:626-962-3203
Mailing Address - Street 1:1433 E ROUTE 66
Mailing Address - Street 2:UNIT F
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-3747
Mailing Address - Country:US
Mailing Address - Phone:626-962-3203
Mailing Address - Fax:626-963-0036
Practice Address - Street 1:1433 E ROUTE 66
Practice Address - Street 2:UNIT F
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-3747
Practice Address - Country:US
Practice Address - Phone:626-962-3203
Practice Address - Fax:626-963-0036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAADP190062BP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility