I Choose Life Addiction Specialist

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

I CHOOSE LIFE ADDICTION SPECIALIST

Doing business as

iCLASS Treatment Center

Practice address

425 E 6TH St
Unit 201
Corona, CA 92879-1566

Phone

(951) 339-8443

Fax

(951) 339-8443

NPI assigned

Feb 10, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Renaldo Rolando Moodie Jr., MFTNPI 1740635499

Title

Clinical Therapist

Phone

(951) 339-8443

Specialties & licenses 8

Addresses

Other names 1

• iCLASS Treatment Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Renaldo R. Moodie Jr., LMFT

  • Marriage & Family Therapist
  • Riverside, CA
  • NPI 1740635499
  NPD (past) Authorized official

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

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423526400000",
    "number": "1124419379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3380 LA SIERRA AVE",
            "address_2": "SUITE 104-730",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035271",
            "telephone_number": "951-339-8443",
            "fax_number": "951-339-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E 6TH ST",
            "address_2": "UNIT 201",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928791566",
            "telephone_number": "951-339-8443",
            "fax_number": "951-339-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I CHOOSE LIFE ADDICTION SPECIALIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-10",
        "last_updated": "2015-02-10",
        "status": "A",
        "authorized_official_last_name": "MOODIE",
        "authorized_official_first_name": "RENALDO",
        "authorized_official_middle_name": "ROLANDO",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "951-339-8443",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "iCLASS Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hwang Dental Group Inc
• Cynthia Hwang, SUDCC, CATC IV
• Emily Hwang
• Emily Hyland
• Tiffany Hymon
• Valeria Ibarra-Martinez
• Brenda Ibarra
• Nallely Ibarra
• Dina Ibrahim, O.D.
• Jacqueline Ibrahim, RPH

• Substance Use Disorder Rehabilitation Clinic/Center in Corona, CA
• Providers in Corona, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; 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.