NPIMap

Organization Active NPI

Refuge Treatment Center Inc.

  • Addiction Medicine (Family Medicine) Physician
  • Lake Arrowhead, CA
National Provider Identifier
1013395565
Registry record updated May 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 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
Last updated
May 15, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2015

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0401X CA Primary

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

National Provider Directory

National Provider Directory
Tax ID family
Refuge Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1431648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431648000000",
    "number": "1013395565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1238",
            "city": "LAKE ARROWHEAD",
            "state": "CA",
            "postal_code": "923521238",
            "telephone_number": "909-337-4224",
            "fax_number": "909-336-7357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1366 YELLOWSTONE DR.",
            "city": "LAKE ARROWHEAD",
            "state": "CA",
            "postal_code": "923521238",
            "telephone_number": "909-337-4224",
            "fax_number": "909-336-7357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REFUGE TREATMENT CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-15",
        "last_updated": "2015-05-15",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "LOREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-337-4224"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Arrowhead, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2015; 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.