CHILDREN'S RECOVERY CENTER 1, LLC; NPI #1720597511

Contact Information

CHILDREN'S RECOVERY CENTER 1, LLC

3777 S BASCOM AVE
CAMPBELL, CA 95008-7320

Phone: 408-558-3640
Fax: 408-340-1519
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Children	282NC2000X	A0[7]	Hospital-Childrenâ€™s (PPS excluded)

Indicates primary specialty

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

NPI Number	`1720597511`
LBN Legal business name	CHILDREN'S RECOVERY CENTER 1, LLC
Authorized official	DAN NICCUM - (CEO)
Entity	Organization
Organization subpart ¹	Yes
Enumeration date	09/25/2017
Last updated	06/22/2023 - About 3 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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CHILDREN'S RECOVERY CENTER 1, LLC

Contact Information

Specialty

Children

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

Reviews for CHILDREN'S RECOVERY CENTER 1, LLC