Sparkles KC LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SPARKLES KC LLC

Practice address

10002 Briley Way
Villa Park, CA 92861-4219

Phone

(949) 289-0350

NPI assigned

Jun 3, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Izzy Hirson

Title

Ceo

Phone

(949) 289-0350

Specialties & licenses 1

Addresses

Other names 1

• Path To Serenity Doing business as

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464912000000",
    "number": "1073962791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CHESHIRE CT",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926604210",
            "telephone_number": "949-289-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10002 BRILEY WAY",
            "city": "VILLA PARK",
            "state": "CA",
            "postal_code": "928614219",
            "telephone_number": "949-289-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARKLES KC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-03",
        "last_updated": "2016-06-03",
        "status": "A",
        "authorized_official_last_name": "HIRSON",
        "authorized_official_first_name": "IZZY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-289-0350",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Path To Serenity",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patrick Rocillo
• Jospeh A Ropel
• Eddie J Scales, M.D.
• Eric Martin Sense, DC
• Rajesh Sharma, MSW, BCBA
• Rajagopal Keerthy Sunder, M.D.
• Sunrise Holistic Care Inc
• Victoria Barrett Taylor, M.A., BCBA
• Tustin Community Pharmacy Inc
• VPRP, Inc.

• Substance Abuse Rehabilitation Facility in Villa Park, CA
• Providers in Villa Park, 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 Jun 3, 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.