Socal Recovery Centers, Inc.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

190787AP Issued in CA

Legal business name

SOCAL RECOVERY CENTERS, INC.

Practice address

6315 Bonsall Dr
Malibu, CA 90265-3827

Phone

(310) 699-7482

NPI assigned

Oct 17, 2013

Organization subpart

No

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

Authorized official

Name

Jack Green

Title

Owner

Phone

(310) 699-7482

Specialties & licenses 1

Addresses

Other names 1

• Malibu Life Recovery Center Doing business as

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

{
    "created_epoch": "1381968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382313600000",
    "number": "1124456777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 197",
            "city": "LAKE ARROWHEAD",
            "state": "CA",
            "postal_code": "923520197",
            "telephone_number": "310-699-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6315 BONSALL DR",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902653827",
            "telephone_number": "310-699-7482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCAL RECOVERY CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-17",
        "last_updated": "2013-10-21",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-699-7482"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190787AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Malibu Life Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristine Alice Smylie, MA, MA, MFT
• Katherine Sniffen, ATC
• Soba Living LLC
• Soba Outpatient and Recovery LLC
• Socal Psych, Inc
• Shahram Soroudi, PHARMD
• William David Stanley, MD
• Star & Sky Physical Therapy, Inc
• Robin Steinberg, LMFT
• Barbara Stern, R.N.

• Substance Abuse Rehabilitation Facility in Malibu, CA
• Providers in Malibu, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2013; 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.