Healing Waters Recovery Palm Dr, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

201617610562 Issued in CA

Legal business name

HEALING WATERS RECOVERY PALM DR, LLC

Practice address

19069 Van Buren Blvd
114 116
Riverside, CA 92508-9169

Phone

(772) 233-0677

NPI assigned

Oct 9, 2016

Last updated

Oct 9, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

HEALING WATERS RECOVERY DHS, LLCAs reported in NPPES

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

Authorized official

Name

Mrs. Darlene Marie Leon

Title

President

Phone

(772) 233-0677

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1475971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475971200000",
    "number": "1043760507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11220 PALM DR",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922403163",
            "telephone_number": "760-676-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19069 VAN BUREN BLVD",
            "address_2": "114 116",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925089169",
            "telephone_number": "772-233-0677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING WATERS RECOVERY PALM DR, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALING WATERS RECOVERY DHS, LLC",
        "enumeration_date": "2016-10-09",
        "last_updated": "2016-10-09",
        "status": "A",
        "authorized_official_last_name": "LEON",
        "authorized_official_first_name": "DARLENE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-233-0677",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "201617610562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Healing Horizon Behavior Solutions, LLC
• Healing Sanctum-Elsinore Inc
• Healing Touch Nurses Group
• Healing Tree & Wellness Center Inc
• Healing Tree Wellness Center Inc
• Health Diagnostics of California a Professional Corporation
• Health Is Wealth MH Solutions Licensed Clinical Social Worker
• Health to Home Central Inc
• Health to Home, Inc
• Health View

• Substance Abuse Rehabilitation Facility in Riverside, CA
• Providers in Riverside, 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 Oct 9, 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.