South Lake Tahoe Recovery and Rehabilitation, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

SOUTH LAKE TAHOE RECOVERY AND REHABILITATION, LLC

Practice address

591 Tahoe Keys Blvd Ste D2
South Lake Tahoe, CA 96150-3359

Phone

(530) 539-9029

NPI assigned

Nov 5, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Nathan Tuddenham

Title

Chief Operating Officer

Phone

(831) 740-4629

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663632000000",
    "number": "1043788359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 GAFFEY RD",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950769731",
            "telephone_number": "831-740-4629",
            "fax_number": "831-708-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 TAHOE KEYS BLVD STE D2",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961503359",
            "telephone_number": "530-539-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH LAKE TAHOE RECOVERY AND REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-05",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A",
        "authorized_official_last_name": "TUDDENHAM",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "831-740-4629",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Pittlick Smith, NP
• Mary Rhonda Sneeringer, MD
• Samantha Snyder
• South Lake Tahoe
• South Lake Tahoe Family Resource Center
• South Lake Tahoe Therapy, Licensed Clinical Social Worker Inc.
• South Tahoe Anesthesia Medical Group
• Delicia Marilyn Spees I
• Adam Spindler, DC
• Gail St.James, MFTI

• Substance Use Disorder Rehabilitation Clinic/Center in South Lake Tahoe, CA
• Providers in South Lake Tahoe, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.