NPIMap

Organization Active NPI

Sun Street Centers

  • Substance Abuse Rehabilitation Facility
  • King City, CA
National Provider Identifier
1164904108
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
SUN STREET CENTERS
Practice address
637 Broadway St
King City, CA 93930-3231
Phone
(831) 525-8101
Fax
(831) 525-8130
NPI assigned
Sep 6, 2018
Last updated
Jun 11, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
SUN STREET CENTERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Gordon William Horne, LAADCNPI 1013116631
Title
Clinical Supervisor
Phone
(831) 809-8176

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

637 Broadway St
King City, CA 93930-3231

Mailing address

11 Peach Dr
Salinas, CA 93901-3710
Phone (831) 753-5145

Other identifiers 1

IdentifierTypeStateIssuer
270003HNOtherCACA DHCS

National Provider Directory

National Provider Directory
Tax ID family
Sun Street Centers Outpatient Recovery Services13 organizations share this tax ID, including this one
Part of
Sun Street Centers Outpatient Recovery Services

Other organizations with this tax ID 12

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

Locations

637 Broadway St
King City, CA 93930
Phone (831) 525-8101

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1164904108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 PEACH DR",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939013710",
            "telephone_number": "831-753-5145",
            "fax_number": "831-753-6005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 BROADWAY ST",
            "city": "KING CITY",
            "state": "CA",
            "postal_code": "939303231",
            "telephone_number": "831-525-8101",
            "fax_number": "831-525-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN STREET CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUN STREET CENTERS",
        "enumeration_date": "2018-09-06",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "HORNE",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "831-809-8176",
        "authorized_official_credential": "LAADC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA DHCS",
            "identifier": "270003HN",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in King City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.