Provider Demographics
NPI:1851914212
Name:URP CALIFORNIA LLC
Entity Type:Organization
Organization Name:URP CALIFORNIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MACDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-654-9072
Mailing Address - Street 1:120 N FEDERAL HWY STE 206
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-3493
Mailing Address - Country:US
Mailing Address - Phone:772-812-9652
Mailing Address - Fax:954-251-3718
Practice Address - Street 1:210 W 6TH ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-2102
Practice Address - Country:US
Practice Address - Phone:954-654-9072
Practice Address - Fax:954-251-3718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-20
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility