| NPI | 1164511465 |
|---|---|
| Doing Business As | PROVIDENCE RECOVERY CENTER |
| Entity Type | Organization |
| Authorized Contact | CLAUDIA JANE PORTER Executive Director 831-475-1326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 440013AP) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2010-05-18 |