Irecovery Behavioral Health Clinic, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

IRECOVERY BEHAVIORAL HEALTH CLINIC, LLC

Doing business as

iRecovery Santa Maria

Practice address

607 Plaza Dr
Suite C-102
Santa Maria, CA 93454-6944

Phone

(805) 631-5268

Fax

(805) 631-5264

NPI assigned

Jun 29, 2016

Organization subpart

No

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

Authorized official

Name

John Kroll

Title

Supervisor

Phone

(805) 631-5268

Specialties & licenses 1

Addresses

Other names 1

• iRecovery Santa Maria Doing business as

Tax ID family

Irecover2 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.

• Irecover

  • Community/Behavioral Health Agency
  • Santa Maria, CA
  • NPI 1366894438
  NPD tax ID

Locations

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467158400000",
    "number": "1164873253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68778 E PALM CANYON DR",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922341313",
            "telephone_number": "805-631-5268",
            "fax_number": "805-631-5264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 PLAZA DR",
            "address_2": "SUITE C-102",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934546944",
            "telephone_number": "805-631-5268",
            "fax_number": "805-631-5264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRECOVERY BEHAVIORAL HEALTH CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-29",
        "last_updated": "2016-06-29",
        "status": "A",
        "authorized_official_last_name": "KROLL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "805-631-5268"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "iRecovery Santa Maria",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa In
• Industrial Medical Group of Santa Maria Valley
• Infinite Hope Housing LLC
• Richard A. Insco, M.D.
• Irecover
• Jennifer Elizabeth Ireland, MFTI
• Naomi Ishibashi, DDS
• Laura Ishikawa
• Patricia Isom, LCSW
• Jasmyn Isomura

• Substance Use Disorder Rehabilitation Clinic/Center in Santa Maria, CA
• Providers in Santa Maria, 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 Jun 29, 2016; 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.