Providence Recovery Center, Inc.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

440013AP Issued in CA

Legal business name

PROVIDENCE RECOVERY CENTER, INC.

Practice address

831 Paget Ave
Santa Cruz, CA 95062-4112

Phone

(831) 475-1326

Fax

(831) 475-7881

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Claudia Jane Porter, CAC

Title

Executive Director

Phone

(831) 475-1326

Specialties & licenses 1

Addresses

Other names 1

• Providence Recovery Center Doing business as

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274140800000",
    "number": "1164511465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 701",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950100701",
            "telephone_number": "831-475-1326",
            "fax_number": "831-475-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 PAGET AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950624112",
            "telephone_number": "831-475-1326",
            "fax_number": "831-475-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE RECOVERY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2010-05-18",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "CLAUDIA",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "831-475-1326",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CAC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "440013AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ann Prindiville, LCSW
• Erica Danielle Prindle
• Riley Pringle
• Lois A Prislovsky, PH.D.
• Amani Pritchard
• Judy Pruzinsky, L.AC.
• Maria Fernanda Pryce Echeverry
• Leping Pu, MD
• Public Health
• Bridget Alison Puchalsky, L.AC.

• All providers in Santa Cruz, CA
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2010; 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.