South Stockton Circle of Friends Adult Alcohol and Drug Treatment Fac.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SOUTH STOCKTON CIRCLE OF FRIENDS ADULT ALCOHOL AND DRUG TREATMENT FAC.

Practice address

1484 Carpenter Rd
Stockton, CA 95206-3805

Phone

(209) 954-6525

Fax

(209) 475-8705

NPI assigned

Jan 13, 2016

Organization subpart

No

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

Authorized official

Name

Wayne Richardson

Title

Ceo

Phone

(209) 954-6525

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph William Bernstein

  • Addiction (Substance Use Disorder) Counselor
  • Stockton, CA
  • NPI 1114326568
  NPD (past)

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452643200000",
    "number": "1225494776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1484 CARPENTER RD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952063805",
            "telephone_number": "209-954-6525",
            "fax_number": "209-475-8705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1484 CARPENTER RD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952063805",
            "telephone_number": "209-954-6525",
            "fax_number": "209-475-8705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH STOCKTON CIRCLE OF FRIENDS ADULT ALCOHOL AND DRUG TREATMENT FAC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-13",
        "last_updated": "2016-01-13",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-954-6525"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Stockton, CA
• Providers in Stockton, 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 13, 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.