Organization · Type 2 NPI
I Choose Life Addiction Specialist
Substance Use Disorder Rehabilitation Clinic/Center · Corona, CA
NPI number
1124419379
Active
Practice location
425 E 6th St, Unit 201
Corona, CA 92879-1566
Fax (951) 339-8443
Mailing address
3380 La Sierra Ave, Suite 104-730
Riverside, CA 92503-5271
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Case Management Agency | 251B00000X | None listed |
| Community/Behavioral Health Agency | 251S00000X | None listed |
| Clinic/Center | 261Q00000X | None listed |
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | None listed |
| Adult Mental Health Clinic/Center | 261QM0850X | None listed |
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | None listed |
| Comprehensive Outpatient Rehabilitation Facility (CORF) | 261QR0401X | None listed |
| Substance Use Disorder Rehabilitation Clinic/Center Primary | 261QR0405X | None listed |
Substance Use Disorder Rehabilitation Clinic/Center: Definition to come...
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About NPI 1124419379
I Choose Life Addiction Specialist's National Provider Identifier is 1124419379, issued on Feb 10, 2015. The primary taxonomy on file is Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X), and the practice location is in Corona, CA. The record was last updated on Feb 10, 2015.