Provider Demographics
NPI:1063871986
Name:LAKE HUGHES RECOVERY INC.
Entity type:Organization
Organization Name:LAKE HUGHES RECOVERY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-724-0001
Mailing Address - Street 1:28765 PINE CANYON RD
Mailing Address - Street 2:
Mailing Address - City:LAKE HUGHES
Mailing Address - State:CA
Mailing Address - Zip Code:93532-1046
Mailing Address - Country:US
Mailing Address - Phone:661-724-0001
Mailing Address - Fax:661-481-3392
Practice Address - Street 1:48745 THREE POINTS RD
Practice Address - Street 2:
Practice Address - City:LAKE HUGHES
Practice Address - State:CA
Practice Address - Zip Code:93532-1122
Practice Address - Country:US
Practice Address - Phone:661-724-0001
Practice Address - Fax:661-481-3392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-19
Last Update Date:2021-05-10
Deactivation Date:2016-10-25
Deactivation Code:
Reactivation Date:2016-11-29
Provider Licenses
StateLicense IDTaxonomies
CA190867AP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility