NPIMap

Organization Active NPI

Crest Recovery LLC

  • Substance Abuse Rehabilitation Facility
  • Mission Viejo, CA
National Provider Identifier
1023658200
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
CREST RECOVERY LLC
Doing business as
TruVida Recovery
Practice address
24316 Via Madrugada
Mission Viejo, CA 92692-1910
Phone
(833) 233-0091
Fax
(949) 607-3118
NPI assigned
Jan 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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

Authorized official

Name
Ceaira Coffin
Title
Billing Director
Phone
(833) 233-0091

Specialties & licenses 1

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

Addresses

Primary practice location

24316 Via Madrugada
Mission Viejo, CA 92692-1910

Mailing address

23726 Birtcher Dr
Lake Forest, CA 92630-1771
Phone (949) 612-5097

Other identifiers 1

IdentifierTypeStateIssuer
300351FPOtherCADHCS

Other names 1

  • TruVida Recovery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Crest Recovery LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1579046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586304000000",
    "number": "1023658200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23726 BIRTCHER DR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301771",
            "telephone_number": "949-612-5097",
            "fax_number": "949-607-3118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24316 VIA MADRUGADA",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926921910",
            "telephone_number": "833-233-0091",
            "fax_number": "949-607-3118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREST RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A",
        "authorized_official_last_name": "COFFIN",
        "authorized_official_first_name": "CEAIRA",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "833-233-0091"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHCS",
            "identifier": "300351FP",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TruVida Recovery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TruVida Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; 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.