Active NPI
Safe Passage Recoervy LLC
- Substance Use Disorder Rehabilitation Clinic/Center
- San Rafael, CA
National Provider Identifier
1073974598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/Center
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider DirectoryNPI 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.