CHILDREN'S RECOVERY CENTER 1 LLC NPI 1720597511

NPI Information

NPI: 1720597511
Provider Name: CHILDREN'S RECOVERY CENTER 1, LLC
Classification: General Acute Care Hospital - 282NC2000X
Entity Type: Organization

Specialization: Children

CLIA Number: 05D0932970

Address:
3777 S BASCOM AVE
CAMPBELL, CA
ZIP 95008
Phone: (408) 558-3640
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CHILDREN'S RECOVERY CENTER 1, LLC is a children general acute care hospital in Campbell, CA. CHILDREN'S RECOVERY CENTER 1, LLC NPI is 1720597511. The provider is registered as an organization entity type.

The provider's business location address is:

3777 S BASCOM AVE
CAMPBELL, CA
ZIP 95008-320
Phone: (408) 558-3640
Fax: (408) 340-1519

The provider's authorized official is Dan Niccum .
The authorized official title is Ceo and has the following contact phone number (916) 425-1171.

The CLIA number assigned to this NPI record is 05D0932970 - hospital with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/25/2017 and was last updated on 6/22/2023.

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
1	282NC2000X	General Acute Care Hospital	Children			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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