EVANS LANE WELLNESS AND RECOVERY CENTER NPI 1952635856

NPI Information

EVANS LANE WELLNESS AND RECOVERY CENTER is a community based residential treatment facility mental illness in San Jose, CA. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. EVANS LANE WELLNESS AND RECOVERY CENTER NPI is 1952635856. The provider is registered as an organization entity type.

The provider's business location address is:

2090 EVANS LN
SAN JOSE, CA
ZIP 95125-072
Phone: (408) 793-2406

The provider's authorized official is Sherry Johnson .
The authorized official title is Licensed Clinical Supervisor and has the following contact phone number (408) 793-2424.

The CLIA number assigned to this NPI record is 05D2221745 - ancillary test site with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/24/2009 and was last updated on 9/24/2009.

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:

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.