Provider Demographics
NPI:1609352186
Name:MOUNTAIN SPRINGS RECOVERY LLC
Entity Type:Organization
Organization Name:MOUNTAIN SPRINGS RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING & RCM
Authorized Official - Prefix:MR
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:RAGLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-835-4369
Mailing Address - Street 1:30950 RANCHO VIEJO RD STE 225
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-1772
Mailing Address - Country:US
Mailing Address - Phone:949-627-8991
Mailing Address - Fax:
Practice Address - Street 1:1865 WOODMOOR DR
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132
Practice Address - Country:US
Practice Address - Phone:949-627-8991
Practice Address - Fax:949-835-4369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-17
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility