NPIMap

Organization Active NPI

Kool Living Inc.

Doing business as Footprints Behavioral Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Mission Viejo, CA
National Provider Identifier
1295129112
Registry record updated Dec 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
KOOL LIVING INC.
Doing business as
Footprints Behavioral Health
Practice address
26421 Crown Valley Pkwy
Suite 200
Mission Viejo, CA 92691-8564
Phone
(866) 921-3778
NPI assigned
Mar 28, 2015
Last updated
Dec 23, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
KOOL LIVING INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 23, 2016

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

Authorized official

Name
Nicholas Russi, LAADC CCS
Title
Vice-President
Phone
(951) 427-4807

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

26421 Crown Valley Pkwy
Suite 200
Mission Viejo, CA 92691-8564

Mailing address

20138 Elkwood St
Winnetka, CA 91306-2312

Other names 1

  • Footprints Behavioral Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kool Living Inc9 organizations share this tax ID, including this one
Part of
Kool Living Inc

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

26421 Crown Valley Pkwy
Ste 200
Mission Viejo, CA 92691
Phone (866) 921-3778

NPI Registry JSON

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

{
    "created_epoch": "1427500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482451200000",
    "number": "1295129112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20138 ELKWOOD ST",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913062312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26421 CROWN VALLEY PKWY",
            "address_2": "SUITE 200",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918564",
            "telephone_number": "866-921-3778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOOL LIVING INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KOOL LIVING INC",
        "enumeration_date": "2015-03-28",
        "last_updated": "2016-12-23",
        "status": "A",
        "authorized_official_last_name": "RUSSI",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "951-427-4807",
        "authorized_official_credential": "LAADC CCS"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Footprints Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.