Sanctuary of Transformation LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

300008AP Issued in CA

Legal business name

SANCTUARY OF TRANSFORMATION LLC

Practice address

24381 Spartan St
Mission Viejo, CA 92691

Phone

(949) 215-6602

NPI assigned

Jan 16, 2018

Organization subpart

No

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

Authorized official

Name

Don Bautista

Title

Owner

Phone

(949) 439-3640

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1516060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1194233825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29911 NIGUEL RD",
            "address_2": "STE 7723",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "92607",
            "telephone_number": "949-439-3640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24381 SPARTAN ST",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92691",
            "telephone_number": "949-215-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANCTUARY OF TRANSFORMATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-16",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "DON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-439-3640"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "300008AP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHCS CERTIFICATION",
            "identifier": "300008AP",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.