Provider Demographics
NPI:1164686085
Name:ANAMIKA RECOVERY CENTER, INC.
Entity type:Organization
Organization Name:ANAMIKA RECOVERY CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SUBODH
Authorized Official - Middle Name:SIMON
Authorized Official - Last Name:KARMARKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:714-974-4673
Mailing Address - Street 1:144 S PERALTA HILLS DR
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-3431
Mailing Address - Country:US
Mailing Address - Phone:877-947-6237
Mailing Address - Fax:714-974-4674
Practice Address - Street 1:144 S PERALTA HILLS DR
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-3431
Practice Address - Country:US
Practice Address - Phone:877-947-6237
Practice Address - Fax:714-974-4674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300200AP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility