NPIMap

Organization Active NPI

Helen Vine Recovery Center

  • Substance Abuse Rehabilitation Facility
  • San Rafael, CA
National Provider Identifier
1003206228
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
210017DN Issued in CA
Legal business name
HELEN VINE RECOVERY CENTER
Practice address
291 Smith Ranch Rd
San Rafael, CA 94903-5551
Phone
(415) 492-0818
NPI assigned
Jan 26, 2015
Organization subpart
Yes
Parent organization
BUCKELEW PROGRAMSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John Christopher Kughn, LMFT
Title
Ceo
Phone
(415) 457-6964

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 210017DN CA Primary

Addresses

Primary practice location

291 Smith Ranch Rd
San Rafael, CA 94903-5551

Mailing address

201 Alameda del Prado Ste 103
Novato, CA 94949-6698
Phone (415) 457-6964

National Provider Directory

National Provider Directory
Tax ID family
Buckelew Programs13 organizations share this tax ID, including this one
Part of
Buckelew Programs

Other organizations with this tax ID 12

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

Locations

291 Smith Ranch Rd
San Rafael, CA 94903
Phone (415) 492-0818

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 31

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1003206228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 ALAMEDA DEL PRADO STE 103",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949496698",
            "telephone_number": "415-457-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 SMITH RANCH RD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949035551",
            "telephone_number": "415-492-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HELEN VINE RECOVERY CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BUCKELEW PROGRAMS",
        "enumeration_date": "2015-01-26",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "KUGHN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "415-457-6964",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "210017DN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.