NPIMap

Organization Active NPI

Modern Recovery Inc.

Doing business as Virgil- Irvine

  • Adult Mental Health Clinic/Center
  • Irvine, CA
National Provider Identifier
1013676634
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
MODERN RECOVERY INC.
Doing business as
Virgil- Irvine
Practice address
4199 Campus Dr Ste 550
Irvine, CA 92612-4694
Phone
(844) 991-0555
NPI assigned
Dec 10, 2021
Last updated
Dec 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Authorized official

Name
Andre Bahbah
Title
Director of RCM
Phone
(844) 991-0555

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU Primary
Substance Abuse Rehabilitation Facility 324500000X NU

Addresses

Primary practice location

4199 Campus Dr Ste 550
Irvine, CA 92612-4694

Mailing address

4199 Campus Dr Ste 550
Irvine, CA 92612-4694

Other names 1

  • Virgil- Irvine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Modern Recovery Inc14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1639094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639094400000",
    "number": "1013676634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4199 CAMPUS DR STE 550",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926124694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4199 CAMPUS DR STE 550",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926124694",
            "telephone_number": "844-991-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN RECOVERY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-10",
        "last_updated": "2021-12-10",
        "certification_date": "2021-11-22",
        "status": "A",
        "authorized_official_last_name": "BAHBAH",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "DIRECTOR OF RCM",
        "authorized_official_telephone_number": "844-991-0555"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Virgil- Irvine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; 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.