Dr Recovery Encinitas LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

370143AP Issued in CA

Legal business name

DR RECOVERY ENCINITAS LLC

Practice address

609 S. Vulcan Ave Ste 301
Encinitas, CA 92024

Phone

(949) 419-4929

Fax

(949) 484-7021

NPI assigned

Jan 20, 2015

Last updated

Mar 19, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Nate Izzo

Title

Office Manager

Phone

(949) 419-4929

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1421712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552953600000",
    "number": "1184013781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 S VULCAN AVE STE 301",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920243600",
            "telephone_number": "949-419-4929",
            "fax_number": "949-542-3878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 S. VULCAN AVE STE 301",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "92024",
            "telephone_number": "949-419-4929",
            "fax_number": "949-484-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR RECOVERY ENCINITAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-20",
        "last_updated": "2019-03-19",
        "status": "A",
        "authorized_official_last_name": "IZZO",
        "authorized_official_first_name": "NATE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "949-419-4929",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CA",
            "license": "370143AP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTHCARE SERVICES DHHS",
            "identifier": "370143AP",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D2083893",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Encinitas, CA
• Providers in Encinitas, 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 Mar 19, 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.