Refuge Treatment Center Inc.

Organization Active NPI Addiction Medicine (Family Medicine) Physician · Lake Arrowhead, CA

NPI 1013395565 · NPPES record last updated May 15, 2015

Key facts

NPI
1013395565
Entity type
Organization (NPI type 2)
Primary specialty
Addiction Medicine (Family Medicine) Physician 207QA0401X
Legal business name
REFUGE TREATMENT CENTER INC.
Practice address
1366 Yellowstone Dr.
Lake Arrowhead, CA 92352-1238
Phone
(909) 337-4224
Fax
(909) 336-7357
NPI assigned
May 15, 2015
Organization subpart
No

Authorized official

Name
Nathan Loren Ingram
Title
Owner
Phone
(909) 337-4224

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Refuge Inc (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207QA0401X CA Yes

Addresses

Primary practice location

1366 Yellowstone Dr.
Lake Arrowhead, CA 92352-1238

Mailing address

PO Box 1238
Lake Arrowhead, CA 92352-1238
Phone (909) 337-4224

Other providers in Lake Arrowhead, CA

All providers in Lake Arrowhead, CA · Addiction Medicine (Family Medicine) Physician in California

Sources for this page

Verify at the official NPI Registry.