Provider Demographics
NPI:1518183243
Name:RECOVERY TREATMENT CENTER
Entity Type:Organization
Organization Name:RECOVERY TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:BRITO
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:909-625-3818
Mailing Address - Street 1:244 ALPINE ST
Mailing Address - Street 2:APT D
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-5206
Mailing Address - Country:US
Mailing Address - Phone:909-625-3818
Mailing Address - Fax:
Practice Address - Street 1:244 ALPINE ST
Practice Address - Street 2:APT D
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-5206
Practice Address - Country:US
Practice Address - Phone:909-625-3818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3613261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone