NPIMap

Organization Active NPI

Refuge Inc

  • Substance Abuse Rehabilitation Facility
  • Lake Arrowhead, CA
National Provider Identifier
1124435755
Registry record updated Jul 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
360094AP Issued in CA
Legal business name
REFUGE INC
Practice address
1366 Yellowstone Dr
Lake Arrowhead, CA 92352-1238
Phone
(909) 337-4224
Fax
(888) 509-3920
NPI assigned
Jul 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2014

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

Authorized official

Name
Kellie M Terry
Title
Billing Manager
Phone
(909) 379-9237

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 360094AP CA Primary

Addresses

Primary practice location

1366 Yellowstone Dr
Lake Arrowhead, CA 92352-1238

Mailing address

PO Box 1238
1366 Yellowstone Dr
Lake Arrowhead, CA 92352-1238
Phone (909) 337-4224

Other identifiers 1

IdentifierTypeStateIssuer
360094APOtherCACA LIC

National Provider Directory

National Provider Directory
Tax ID family
Refuge Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405382400000",
    "number": "1124435755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1238",
            "address_2": "1366 YELLOWSTONE DR",
            "city": "LAKE ARROWHEAD",
            "state": "CA",
            "postal_code": "923521238",
            "telephone_number": "909-337-4224",
            "fax_number": "888-509-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1366 YELLOWSTONE DR",
            "city": "LAKE ARROWHEAD",
            "state": "CA",
            "postal_code": "923521238",
            "telephone_number": "909-337-4224",
            "fax_number": "888-509-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REFUGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-15",
        "last_updated": "2014-07-15",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "909-379-9237"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "360094AP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LIC",
            "identifier": "360094AP",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Arrowhead, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; 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.