| Hope Canyon | |
|
2821 Lange Ave San Diego CA 92122-3109 | |
| (855) 804-6503 | |
| Not Available |
| Full Name | Hope Canyon |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 2821 Lange Ave, San Diego, California |
| Authorized Official Name and Position | Robert Niznik (CEO) |
| Authorized Official Contact | 8558046503 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hope Canyon 1515 Nw 167th St Ste 300 Miami Gardens FL 33169-5106 Ph: (786) 923-3376 | Hope Canyon 2821 Lange Ave San Diego CA 92122-3109 Ph: (855) 804-6503 |
| NPI Number | 1992216063 |
|---|---|
| Provider Enumeration Date | 10/17/2017 |
| Last Update Date | 06/04/2020 |
| Certification Date | 06/04/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992216063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | (California) | Primary |
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