NPIMap

Organization Active NPI

County of Calaveras

  • Substance Use Disorder Rehabilitation Clinic/Center
  • San Andreas, CA
National Provider Identifier
1053972885
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
COUNTY OF CALAVERAS
Practice address
590 Toyanza Drive
San Andreas, CA 95249-9713
Phone
(209) 754-6525
Fax
(209) 754-6597
NPI assigned
Jun 24, 2019
Last updated
Sep 16, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
CALAVERAS COUNTY SUBSTANCE ABUSE PROGRAMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Authorized official

Name
Stacey Meily
Title
BHS Program Manager
Phone
(209) 754-6516

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

590 Toyanza Drive
San Andreas, CA 95249-9713

Mailing address

891 Mountain Ranch Rd
San Andreas, CA 95249-9713
Phone (209) 754-6525

National Provider Directory

National Provider Directory
Tax ID family
Calaveras County Public8 organizations share this tax ID, including this one
Part of
Calaveras County Public

Other organizations with this tax ID 7

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

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": "1561334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757980800000",
    "number": "1053972885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "891 MOUNTAIN RANCH RD",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952499713",
            "telephone_number": "209-754-6525",
            "fax_number": "209-754-6597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 TOYANZA DRIVE",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952499713",
            "telephone_number": "209-754-6525",
            "fax_number": "209-754-6597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF CALAVERAS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CALAVERAS COUNTY SUBSTANCE ABUSE PROGRAM",
        "enumeration_date": "2019-06-24",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A",
        "authorized_official_last_name": "MEILY",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "BHS PROGRAM MANAGER",
        "authorized_official_telephone_number": "209-754-6516"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Andreas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; 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.