National Provider Identifier Database

CHILDRENS RECOVERY CENTER 1 LLC
Children


Contact Information

CHILDREN'S RECOVERY CENTER 1, LLC
3777 S. BASCOM AVE.
CAMPBELL, CA95008
Phone: 408-340-1568
Fax: 408-866-8144
Website:
Specialty Taxonomy Code
* Children 282NC2000X

* Indicates primary specialty

NPI Profile & details for CHILDREN'S RECOVERY CENTER 1, LLC

NPI Number 1114006830
Legal business name
LBN
CHILDREN'S RECOVERY CENTER 1, LLC
Authorized official KENNETH MCGUIRE - (PRESIDENT/CEO)
Entity Organization
Organization subpart No
Enumeration date 11/03/2006
Last updated 02/08/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers
  • CA License #: 070000320

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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