Provider Demographics
NPI:1922526425
Name:TOO BE FREE RECOVERY INCORPORATED
Entity Type:Organization
Organization Name:TOO BE FREE RECOVERY INCORPORATED
Other - Org Name:TOO BE FREE RECOVERY INCORPORATED
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:MISS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:YEVETTE
Authorized Official - Last Name:HARVEYFULLER
Authorized Official - Suffix:
Authorized Official - Credentials:BA, MA
Authorized Official - Phone:800-953-1383
Mailing Address - Street 1:PO BOX 411
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:91752-0411
Mailing Address - Country:US
Mailing Address - Phone:800-953-1383
Mailing Address - Fax:800-369-3889
Practice Address - Street 1:1799 N WATERMAN AVE STE F
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-5107
Practice Address - Country:US
Practice Address - Phone:951-347-3672
Practice Address - Fax:800-369-3998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-05
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA360112AN261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder