| Living Proof Recovery Center | |
|
324 W Foothill Blvd Monrovia CA 91016-2149 | |
| (626) 205-2518 | |
| (626) 446-5910 |
| Full Name | Living Proof Recovery Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 324 W Foothill Blvd, Monrovia, California |
| Authorized Official Name and Position | Gerald M Pool (OWNER/DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 6262052518 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Proof Recovery Center Po Box 2420 Monrovia CA 91017-6420 Ph: (626) 205-2518 | Living Proof Recovery Center 324 W Foothill Blvd Monrovia CA 91016-2149 Ph: (626) 205-2518 |
| NPI Number | 1790924132 |
|---|---|
| Provider Enumeration Date | 02/09/2009 |
| Last Update Date | 05/17/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790924132 | NPI | - | NPPES |
| 190316BP | Other | CA | DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 190316BP (California) | Primary |
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