| Crescent Moon Recovery, Llc | |
|
18377 Beach Blvd Ste 210 Huntington Beach CA 92648-1349 | |
| (714) 841-2260 | |
| Not Available |
| Full Name | Crescent Moon Recovery, Llc |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 18377 Beach Blvd Ste 210, Huntington Beach, California |
| Authorized Official Name and Position | Adam Wade (CEO) |
| Authorized Official Contact | 6617068898 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crescent Moon Recovery, Llc 18377 Beach Blvd Ste 210 Huntington Beach CA 92648-1349 Ph: (714) 841-2260 | Crescent Moon Recovery, Llc 18377 Beach Blvd Ste 210 Huntington Beach CA 92648-1349 Ph: (714) 841-2260 |
| NPI Number | 1083200307 |
|---|---|
| Provider Enumeration Date | 12/21/2020 |
| Last Update Date | 01/10/2022 |
| Certification Date | 01/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083200307 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
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