SHANNON DENISE REILLY CAS - NPI 1891937306 - Substance Abuse Rehabilitation Facility in Pollock Pines, CA

Q: What is the provider's specialty?

The provider's specialty is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

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About Shannon Denise Reilly Cas NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANNON DENISE REILLY CAS (NPI 1891937306) is an individual substance abuse rehabilitation facility provider in Pollock Pines, California, licensed in California (324500000X) and active in the NPI registry since March 2009.

NPPES Registry Identity

NPI1891937306

Entity TypeIndividualFemale

Primary Taxonomy324500000X

Provider Legal NameSHANNON DENISE REILLYCredential: CAS

Location Address5494 PONY EXPRESS TRAILPollock Pines, CA 95726

Mailing AddressPo Box 586Camino, CA 95709-0586 · (530) 644-3758 · Fax (530) 644-3782

Phone(530) 644-3758

Fax(530) 644-3782

Sole ProprietorYes

Enumeration DateMarch 30, 2009

✔ NPI 1891937306 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities

Taxonomy Code324500000X

License✔ Licensed in CA · 324500000X

Definition

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

5494 PONY EXPRESS TRAIL, Pollock Pines, CA 95726

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