NPIMap

Organization Active NPI

My Time Recovery, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fresno, CA
National Provider Identifier
1114431897
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
MY TIME RECOVERY, LLC
Practice address
83 E Shaw Ave Ste 200-204
Fresno, CA 93710-7620
Phone
(559) 840-0896
Fax
(559) 282-3102
NPI assigned
Nov 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Authorized official

Name
Samantha Barron
Title
Office Manager
Phone
(559) 355-6128

Specialties & licenses 1

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

Addresses

Primary practice location

83 E Shaw Ave Ste 200-204
Fresno, CA 93710-7620

Mailing address

83 E Shaw Ave Ste 202
Fresno, CA 93710-7616

Other identifiers 1

IdentifierTypeStateIssuer
100002BPOtherCADHCS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2156028My Time Recovery LLC83 E Shaw Ave Ste 202, Fresno, CA 93710Certificate of waiverOct 8, 2026
05D2301249My Time Recovery LLC83 E Shaw Ave Ste 200, Fresno, CA 93710Certificate of waiverMar 21, 2028

National Provider Directory

National Provider Directory
Tax ID family
My Time Recovery LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

83 E Shaw Ave
Ste 202
Fresno, CA 93710
Phone (559) 905-9088

83 E Shaw Ave
Ste 200204
Fresno, CA 93710
Phone (559) 840-0896

Ownership & related parties

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648771200000",
    "number": "1114431897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 E SHAW AVE STE 202",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937107616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 E SHAW AVE STE 200-204",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937107620",
            "telephone_number": "559-840-0896",
            "fax_number": "559-282-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY TIME RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-17",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A",
        "authorized_official_last_name": "BARRON",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "559-355-6128"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHCS",
            "identifier": "100002BP",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.