Vivid Recovery, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

VIVID RECOVERY, LLC

Doing business as

Refine Recovery

Practice address

1634 Benedict Canyon Dr
Beverly Hills, CA 90210-2003

Phone

(484) 387-7776

Fax

(310) 861-8830

NPI assigned

Apr 14, 2021

Last updated

May 22, 2024By 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. Peter Cory Raskovic

Title

Ceo

Phone

(484) 387-7776

Specialties & licenses 1

Addresses

Other names 1

• Refine Recovery Doing business as

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1245811025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 BENEDICT CANYON DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902102003",
            "telephone_number": "484-387-7776",
            "fax_number": "310-861-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 BENEDICT CANYON DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902102003",
            "telephone_number": "484-387-7776",
            "fax_number": "310-861-8830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1628 Benedict Canyon Dr",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902102003",
            "country_code": "US",
            "telephone_number": "484-387-7776",
            "fax_number": "310-861-8830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12915 Addison St",
            "address_purpose": "LOCATION",
            "city": "Sherman Oaks",
            "state": "CA",
            "postal_code": "914232248",
            "country_code": "US",
            "telephone_number": "484-387-7776",
            "fax_number": "310-861-8830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12917 Addison St",
            "address_purpose": "LOCATION",
            "city": "Sherman Oaks",
            "state": "CA",
            "postal_code": "914232248",
            "country_code": "US",
            "telephone_number": "484-387-7776",
            "fax_number": "310-861-8830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12919 Addison St",
            "address_purpose": "LOCATION",
            "city": "Sherman Oaks",
            "state": "CA",
            "postal_code": "91423",
            "country_code": "US",
            "telephone_number": "484-387-7776",
            "fax_number": "310-861-8830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VIVID RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-14",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "RASKOVIC",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "CORY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "484-387-7776",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Refine Recovery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Refine Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Substance Abuse Rehabilitation Facility in Beverly Hills, CA
• Providers in Beverly Hills, 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 May 22, 2024; 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.