Pacific City Recovery

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

PACIFIC CITY RECOVERY

Practice address

11851 Wisteria Ave
Fountain Valley, CA 92708-2654

Phone

(949) 642-4150

Fax

(949) 642-3441

NPI assigned

Nov 16, 2016

Organization subpart

Yes

Parent organization

COASTAL RECOVERY, INC.As reported in NPPES

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

Authorized official

Name

Kristin Vournas

Title

Vice President

Phone

(949) 413-3339

Specialties & licenses 1

Addresses

Other names 1

• Pacific City Recovery Doing business as

Tax ID family

Pacific City Recovery2 organizations share this tax ID, including this one

Part of

Pacific City Recovery

Other organizations with this tax ID 1

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

• Coastal Recovery, Inc.

  • Substance Abuse Rehabilitation Facility
  • Fountain Valley, CA
  • NPI 1013459569
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Coastal Recovery, Inc.

  • Substance Abuse Rehabilitation Facility
  • Fountain Valley, CA
  • NPI 1013459569
  NPPES parent name

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

{
    "created_epoch": "1479254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482364800000",
    "number": "1023550431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11851 WISTERIA AVE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082654",
            "telephone_number": "949-642-4150",
            "fax_number": "949-642-3441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11851 WISTERIA AVE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082654",
            "telephone_number": "949-642-4150",
            "fax_number": "949-642-3441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CITY RECOVERY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COASTAL RECOVERY, INC.",
        "enumeration_date": "2016-11-16",
        "last_updated": "2016-12-22",
        "status": "A",
        "authorized_official_last_name": "VOURNAS",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "949-413-3339"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific City Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kim Tran Ovalle, MSW, ASW
• Karen Sue Overall, PHYSICAL THERAPIST
• Michael F Ozaki, MD
• P & T Venture Inc
• Pacific Cardiovascular and Thoracic Associates, Inc.
• Pacific Coast Hematology Oncology Medical Group Inc
• Pacific Coast Institute Rehab and Physical Therapy Inc.
• Pacific Coast Multi Specialty Surgery, LLC
• Pacific Coast Speech Therapy, Inc
• Pacific Endoscopy and Surgery Center, LLC

• Substance Abuse Rehabilitation Facility in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; 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.