NPIMap

Organization Active NPI

My Time Recovery, LLC

  • Substance Abuse Rehabilitation Facility
  • Fresno, CA
National Provider Identifier
1023626694
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
MY TIME RECOVERY, LLC
Practice address
1015 E Indianapolis Ave
Fresno, CA 93704-3819
Phone
(702) 419-2592
NPI assigned
Jul 20, 2020
Organization subpart
Yes
Parent organization
MY TIME RECOVERY, LLC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Authorized official

Name
Nicole Nygren
Title
Operations Manager
Phone
(702) 419-2592

Specialties & licenses 1

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

Addresses

Primary practice location

1015 E Indianapolis Ave
Fresno, CA 93704-3819

Mailing address

83 E Shaw Ave
Fresno, CA 93710-7620

National Provider Directory

National Provider Directory
Tax ID family
My Time Recovery LLC6 organizations share this tax ID, including this one
Part of
My Time Recovery LLC

Other organizations with this tax ID 5

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

Locations

83 E Shaw Ave
Fresno, CA 93710
Phone (559) 300-6775

Ownership & related parties

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.

NPI Registry JSON

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647993600000",
    "number": "1023626694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 E SHAW AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937107620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 E INDIANAPOLIS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937043819",
            "telephone_number": "702-419-2592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY TIME RECOVERY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MY TIME RECOVERY, LLC.",
        "enumeration_date": "2020-07-20",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "NYGREN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "702-419-2592"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.