| Chaparral High Teen Recovery Center | |
|
1035 E Madison Ave El Cajon CA 92021-6226 | |
| (619) 588-5361 | |
| (619) 588-5421 |
| Full Name | Chaparral High Teen Recovery Center |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1035 E Madison Ave, El Cajon, California |
| Authorized Official Name and Position | Audrey Jeanne Mcalister (CEO) |
| Authorized Official Contact | 6194420277 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chaparral High Teen Recovery Center 1400 N Johnson Ave Ste 101 El Cajon CA 92020-1651 Ph: (619) 442-0277 | Chaparral High Teen Recovery Center 1035 E Madison Ave El Cajon CA 92021-6226 Ph: (619) 588-5361 |
| NPI Number | 1124378708 |
|---|---|
| Provider Enumeration Date | 09/11/2012 |
| Last Update Date | 12/17/2021 |
| Certification Date | 12/17/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124378708 | NPI | - | NPPES |
| 378558 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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