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Grand Terrace Detox And Recovery
Substance Abuse Rehabilitation Facility in Lake Elsinore, California
NPI 1154847838

Grand Terrace Detox And Recovery is a Substance Abuse Rehabilitation Facility based in Lake Elsinore, CA. Grand Terrace Detox And Recovery practices in Lake Elsinore, CA. The NPI Number for Grand Terrace Detox And Recovery is 1154847838 and holds a License No. 330168AP (California).

The current practice location address for Grand Terrace Detox And Recovery is 18989 Grand Ave, Lake Elsinore, CA and can be reached out via phone at 954-210-8617 and via fax at 954-982-2827.

Location: 18989 Grand Ave, Lake Elsinore, CA, 92530-6259
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1154847838
Provider Name
Grand Terrace Detox And Recovery
Credential
Provider Entity Type
Organization
Address
18989 Grand Ave, Lake Elsinore, CA, 92530-6259
Phone Number
954-210-8617
Fax Number
954-982-2827
Provider Enumeration Date
08/15/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
330168AP 01 CA LICENSE AND CERTIFICATION
institution
Provider Business Practice Location Address Details
Address
18989 Grand Ave
City
Lake Elsinore
State
California
Zip
92530-6259
Phone Number
954-210-8617
Fax Number
954-982-2827
person
Provider Business Mailing Address Details
Address
18989 Grand Ave
City
Lake Elsinore
State
California
Zip
92530-6259
Phone Number
954-210-8617
Fax Number
954-982-2827
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
-
Taxonomy
324500000X
License No.
330168AP (California)
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
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