Provider Demographics
NPI:1760866149
Name:REFLECTIONS RECOVERY LLC
Entity Type:Organization
Organization Name:REFLECTIONS RECOVERY LLC
Other - Org Name:REFLECTIONS RECOVERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:OSENDORF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-299-1729
Mailing Address - Street 1:337 16TH PL
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-3203
Mailing Address - Country:US
Mailing Address - Phone:714-299-1729
Mailing Address - Fax:714-708-2966
Practice Address - Street 1:337 16TH PL.
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627
Practice Address - Country:US
Practice Address - Phone:714-708-2950
Practice Address - Fax:714-708-2966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300327BP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility