Organization Active NPI

Safe Passage Recoervy LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • San Rafael, CA
National Provider Identifier
1073974598
Registry record updated Mar 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
SAFE PASSAGE RECOERVY LLC
Practice address
880 Las Gallinas Ave Ste 2
San Rafael, CA 94903-3437
Phone
(415) 578-2069
Fax
(415) 578-2823
NPI assigned
Mar 10, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2016

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

Authorized official

Name
Ryan Ashley Fischer
Title
Coo
Phone
(415) 686-6215

Specialties & licenses 1

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

Addresses

Primary practice location

880 Las Gallinas Ave Ste 2
San Rafael, CA 94903-3437

Mailing address

1005 Northgate Dr # 174
San Rafael, CA 94903-2500
Phone (415) 578-2069

Other names 1

  • Safe Passage Recovery Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1457568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457568000000",
    "number": "1073974598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 NORTHGATE DR # 174",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032500",
            "telephone_number": "415-578-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 LAS GALLINAS AVE STE 2",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033437",
            "telephone_number": "415-578-2069",
            "fax_number": "415-578-2823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE PASSAGE RECOERVY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-10",
        "last_updated": "2016-03-10",
        "status": "A",
        "authorized_official_last_name": "FISCHER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "ASHLEY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "415-686-6215"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Safe Passage Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.