| Hidden Hope Residential | |
|
12640 14th St Yucaipa CA 92399-1855 | |
| (626) 797-9977 | |
| (626) 844-2977 |
| Full Name | Hidden Hope Residential |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 12640 14th St, Yucaipa, California |
| Authorized Official Name and Position | John Wright (ADMINISTRATOR) |
| Authorized Official Contact | 6267979977 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hidden Hope Residential 12829 14th St Yucaipa CA 92399-1821 Ph: (626) 797-9977 | Hidden Hope Residential 12640 14th St Yucaipa CA 92399-1855 Ph: (626) 797-9977 |
| NPI Number | 1093122368 |
|---|---|
| Provider Enumeration Date | 07/17/2014 |
| Last Update Date | 07/17/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093122368 | NPI | - | NPPES |
| 360100AP | Other | CA | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 360100AP (California) | Primary |
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