Provider Demographics
NPI:1922459551
Name:TRUE LIFE RECOVERY, INC.
Entity Type:Organization
Organization Name:TRUE LIFE RECOVERY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HAYDEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-446-6281
Mailing Address - Street 1:PO BOX 3097
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92659-0639
Mailing Address - Country:US
Mailing Address - Phone:949-520-0530
Mailing Address - Fax:949-271-4871
Practice Address - Street 1:16832 MAPLE ST
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-2227
Practice Address - Country:US
Practice Address - Phone:949-520-0350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-24
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300631AP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA300631APOtherCALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES