RANCHO RECOVERY LLC NPI 1700560695

NPI Information

  • NPI: 1700560695
  • Provider Name: RANCHO RECOVERY LLC
  • Classification: Substance Abuse Rehabilitation Facility - 324500000X
  • Entity Type: Organization
  • CLIA Number: 05D2284442
  • Address: 13684 JEREMY CT
    RANCHO CUCAMONGA, CA
    ZIP 91739
  • Phone: (909) 476-2023

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NPI Details

RANCHO RECOVERY LLC is a substance abuse rehabilitation facility in Rancho Cucamonga, CA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. RANCHO RECOVERY LLC NPI is 1700560695. The provider is registered as an organization entity type.

The provider's business location address is:

13684 JEREMY CT
RANCHO CUCAMONGA, CA
ZIP 91739-031
Phone: (909) 476-2023
Fax: (909) 697-2900

The provider's authorized official is Samuel Phillips .
The authorized official title is Controller and has the following contact phone number (909) 292-6827.

The CLIA number assigned to this NPI record is 05D2284442 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/12/2023 and was last updated on 6/12/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1324500000XSubstance Abuse Rehabilitation FacilityYes

What is NPI?

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This page was last updated on: 11/21/2025

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