NPIMap

Organization Active NPI

Marin Outpatient and Recovery Services

  • Community/Behavioral Health Agency
  • San Rafael, CA
National Provider Identifier
1285941807
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
210033AN Issued in CA
Legal business name
MARIN OUTPATIENT AND RECOVERY SERVICES
Practice address
710 C St
Suite 8
San Rafael, CA 94901-3853
Phone
(415) 485-6736
Fax
(415) 236-1830
NPI assigned
Sep 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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

Authorized official

Name
Mr. Lindsay Ervin Ferguson Jr., MS, LMFT
Title
Executive Director
Phone
(415) 485-6736

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 210033AN CA Primary

Addresses

Primary practice location

710 C St
Suite 8
San Rafael, CA 94901-3853

Mailing address

710 C St
Suite 8
San Rafael, CA 94901-3853
Phone (415) 485-6736

Other names 1

  • Marin Services for Men, Inc. Other name

National Provider Directory

National Provider Directory

Locations

710 C St
Ste 8
San Rafael, CA 94901
Phone (415) 485-6736

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455580800000",
    "number": "1285941807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 C ST",
            "address_2": "SUITE 8",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013853",
            "telephone_number": "415-485-6736",
            "fax_number": "415-236-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 C ST",
            "address_2": "SUITE 8",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013853",
            "telephone_number": "415-485-6736",
            "fax_number": "415-236-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIN OUTPATIENT AND RECOVERY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-02",
        "last_updated": "2016-02-16",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_middle_name": "ERVIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "415-485-6736",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MS, LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "210033AN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marin Services for Men, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.