Provider Demographics
NPI:1366577207
Name:ARH RECOVERY HOMES, INC.
Entity type:Organization
Organization Name:ARH RECOVERY HOMES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:C
Authorized Official - Last Name:WASKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-236-6657
Mailing Address - Street 1:1101 S WINCHESTER BLVD
Mailing Address - Street 2:SUITE J-220
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-3901
Mailing Address - Country:US
Mailing Address - Phone:408-236-6657
Mailing Address - Fax:408-236-6610
Practice Address - Street 1:1101 S WINCHESTER BLVD
Practice Address - Street 2:SUITE J-220
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3901
Practice Address - Country:US
Practice Address - Phone:408-236-6657
Practice Address - Fax:408-236-6610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA430001EN324500000X
CA430001DN324500000X
CA430001GN324500000X
CA430001FN324500000X
CA430001AN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA430001GNOtherLICENSE AND CERTIFICATION
CA430001DNOtherLICENSE AND CERTIFICATION
CA430001ENOtherLICENSE AND CERTIFICATION
CA430001ANOtherLICENSE AND CERTIFICATION