Provider Demographics
NPI:1962099176
Name:KAMI RECOVERY
Entity type:Organization
Organization Name:KAMI RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-798-2727
Mailing Address - Street 1:PO BOX 1868
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-8868
Mailing Address - Country:US
Mailing Address - Phone:626-798-2727
Mailing Address - Fax:626-798-2777
Practice Address - Street 1:1084 NEW YORK DR
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-3118
Practice Address - Country:US
Practice Address - Phone:626-798-2727
Practice Address - Fax:626-798-2777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility