Active NPI
Successful Alternatives for Addiction & Counseling Services, Inc.
- Methadone Clinic
- Vallejo, CA
National Provider Identifier
1154548535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Methadone Clinic
- License
- 48-04
- Legal business name
- SUCCESSFUL ALTERNATIVES FOR ADDICTION & COUNSELING SERVICES, INC.
- Practice address
- 1628 Broadway Street
Vallejo, CA 94590-2405 - Phone
- (707) 649-8300
- Fax
- (707) 649-8302
- NPI assigned
- Apr 19, 2007
- Organization subpart
- Yes
- Parent organization
- MEDMARK SERVICES, INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bruce Jarvie
- Title
- VP, Treasurer
- Phone
- (214) 379-3300
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 48-02 | CA | |
| Methadone Clinic | 261QM2800X | 48-04 | CA | Primary |
Addresses
Primary practice location
1628 Broadway Street
Vallejo, CA 94590-2405
Mailing address
1720 Lakepointe Dr Ste 117
Lewisville, TX 75057-6425
Phone (214) 379-3300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 48-04 | Other | CA | OTP LICENSE |
Other names 1
- MedMark Treatment Centers - Vallejo
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Opioid treatment program
- Medicare-enrolled since Jan 1, 2020
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200217004930 | CA | Part B Supplier - Opioid Treatment Program (Otp) | 5294162046 |
1 other NPI on this enrollment Practice locations: Hayward, CA; Vallejo, CA |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Methadone Clinic
- Hayward, CA
- NPI 1952529711
O20200217004930
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2029283 | Successful Alternatives for Addiction | Certificate of waiver | Sep 1, 2027 |
National Provider Directory
National Provider Directory- Part of
- Medmark Services Inc
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1777852800000",
"number": "1154548535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1720 LAKEPOINTE DR STE 117",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750576425",
"telephone_number": "214-379-3300",
"fax_number": "214-853-9018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1628 BROADWAY STREET",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945902405",
"telephone_number": "707-649-8300",
"fax_number": "707-649-8302"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUCCESSFUL ALTERNATIVES FOR ADDICTION & COUNSELING SERVICES, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MEDMARK SERVICES, INC",
"enumeration_date": "2007-04-19",
"last_updated": "2026-05-04",
"certification_date": "2026-05-04",
"status": "A",
"authorized_official_last_name": "JARVIE",
"authorized_official_first_name": "BRUCE",
"authorized_official_title_or_position": "VP, TREASURER",
"authorized_official_telephone_number": "214-379-3300"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "48-02",
"primary": false
},
{
"code": "261QM2800X",
"taxonomy_group": "",
"desc": "Clinic/Center, Methadone",
"state": "CA",
"license": "48-04",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTP LICENSE",
"identifier": "48-04",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "MedMark Treatment Centers - Vallejo",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.