Provider Demographics
NPI:1306113956
Name:A BETTER CHOICE RECOVERY CENTER
Entity type:Organization
Organization Name:A BETTER CHOICE RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARKETING DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:RIDEOUT
Authorized Official - Suffix:
Authorized Official - Credentials:BA BUSINESS
Authorized Official - Phone:916-335-2401
Mailing Address - Street 1:8011 CAVE CITY RD.
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:95246
Mailing Address - Country:US
Mailing Address - Phone:209-754-0200
Mailing Address - Fax:209-754-0210
Practice Address - Street 1:8011 CAVE CITY ROAD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN RANCH
Practice Address - State:CA
Practice Address - Zip Code:95246
Practice Address - Country:US
Practice Address - Phone:209-754-0200
Practice Address - Fax:209-754-0210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA050004AP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility