The Camp Recovery Center, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

THE CAMP RECOVERY CENTER, LLC

Practice address

2264 Green Hill Rd
Sebastopol, CA 95472-9034

Phone

(707) 823-5019

Fax

(707) 823-0358

NPI assigned

Feb 20, 2020

Organization subpart

No

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

Authorized official

Name

Brian Farley

Title

VP & Secretary

Phone

(615) 861-6000

Specialties & licenses 1

Addresses

Other names 1

• Azure Acres Recovery Center Doing business as

Tax ID family

Azure Acres Recovery Center8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

• The Camp Recovery Center, LLC

  • Substance Abuse Rehabilitation Facility
  • Scotts Valley, CA
  • NPI 1215368485
  NPD tax ID
• The Camp Recovery Center, LLC

  • Substance Abuse Rehabilitation Facility
  • Sebastopol, CA
  • NPI 1568517050
  NPD tax ID
• The Camp Recovery Center, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Scotts Valley, CA
  • NPI 1700437043
  NPD tax ID
• The Camp Recovery Center, LLC

  • Substance Abuse Rehabilitation Facility
  • Scotts Valley, CA
  • NPI 1972685196
  NPD tax ID
• The Camp Recovery Centers, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Sebastopol, CA
  • NPI 1003383209
  NPD tax ID
• The Camp Recovery Centers, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Campbell, CA
  • NPI 1043787245
  NPD tax ID
• The Camp Recovery Centers, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Sacramento, CA
  • NPI 1811464019
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Irenne Magoulas, L.C.S.W.

  • Clinical Social Worker
  • Sebastopol, CA
  • NPI 1558543975
  NPD (past)

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767657600000",
    "number": "1043843899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 ASPEN GROVE DR STE 900",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370673134",
            "telephone_number": "615-861-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2264 GREEN HILL RD",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954729034",
            "telephone_number": "707-823-5019",
            "fax_number": "707-823-0358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11910 Graton Rd",
            "address_purpose": "LOCATION",
            "city": "Sebastopol",
            "state": "CA",
            "postal_code": "954729700",
            "country_code": "US",
            "telephone_number": "707-823-5019",
            "fax_number": "707-823-0358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE CAMP RECOVERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-20",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A",
        "authorized_official_last_name": "FARLEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "VP & SECRETARY",
        "authorized_official_telephone_number": "615-861-6000"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Azure Acres Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tina Ying Hua Tan
• Paula Tanksley, PT
• Terri Joan Drew
• Terri Turner, D.O., a Professional Corporation
• Davora Tetens, MFT
• The Camp Recovery Center, LLC
• The Camp Recovery Centers, LLC
• The Ceres Community Project
• Paul Frederick Thielen, DDS
• Thrifty Payless Inc

• Substance Abuse Rehabilitation Facility in Sebastopol, CA
• Providers in Sebastopol, 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 Jan 6, 2026; 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.