Children's Recovery Center 1, LLC
NPI #1720597511 in Campbell, California
Provider Information
- NPI Number
- 1720597511
- Entity Type
- Organization
- Organization Name
- Children's Recovery Center 1, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- INNOVATIONS HEALTH SYSTEMS
- Primary Specialty
- General Acute Care Hospital - Children
- Enumeration Date
- Sep 25, 2017
- Last Updated
- Jun 22, 2023
Practice Location
- Address
- 3777 S BASCOM AVE
- City
- Campbell
- State
- California
- ZIP Code
- 95008-7320
- Phone
- (408) 558-3640
Authorized Official
- Name
- DAN NICCUM
- Title
- CEO
- Phone
- (916) 425-1171
Specialties & Taxonomy Codes
| Specialty |
|---|
| General Acute Care Hospital - Children — Children |
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