| Organization Name: | FRED BROWN'S RECOVERY SERVICES, INC. |
| NPI Number: | 1104257369 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROXANNA NATALE-BROWN (EXECUTIVE DIRECTOR) |
| Mailing Address: | 270 W 14th St # 3 San Pedro |
| State: | CA US |
| Postal Code: | 907314315 |
| Phone Number: | 3105198723 |
| Fax Number: | 3105199428 |
| NPI Enumeration Date: | 12/12/2013 |
| NPI Last Update Date: | 12/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | 190135MN |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |