Balboa Horizons Recovery Services LP

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

300165AP Issued in CA

Legal business name

BALBOA HORIZONS RECOVERY SERVICES LP

Practice address

1132 W Balboa Blvd
Newport Beach, CA 92661-1091

Phone

(949) 675-3406

NPI assigned

Jun 25, 2007

Last updated

Aug 22, 2020By 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. Mathias William Arnold Hanck

Title

Business Development Co-Owner

Phone

(714) 801-1839

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194921270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 W BALBOA BLVD",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926611091",
            "telephone_number": "949-675-3406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 W BALBOA BLVD",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926611091",
            "telephone_number": "949-675-3406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALBOA HORIZONS RECOVERY SERVICES LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HANCK",
        "authorized_official_first_name": "MATHIAS WILLIAM",
        "authorized_official_middle_name": "ARNOLD",
        "authorized_official_title_or_position": "BUSINESS DEVELOPMENT CO-OWNER",
        "authorized_official_telephone_number": "714-801-1839",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "300165AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.