Provider Demographics
NPI:1225481419
Name:CALIFORNIA PRIME RECOVERY SERVICES INC
Entity Type:Organization
Organization Name:CALIFORNIA PRIME RECOVERY SERVICES INC
Other - Org Name:CALIFORNIA PRIME RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CARMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-510-3358
Mailing Address - Street 1:17330 NEWHOPE ST STE A
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4225
Mailing Address - Country:US
Mailing Address - Phone:949-510-3358
Mailing Address - Fax:
Practice Address - Street 1:17330 NEWHOPE ST STE A
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4225
Practice Address - Country:US
Practice Address - Phone:949-510-3358
Practice Address - Fax:714-434-8034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-22
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility