NPIMap

Organization Active NPI

Central California Recovery

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fresno, CA
National Provider Identifier
1295972446
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
CENTRAL CALIFORNIA RECOVERY
Practice address
1204 W Shaw Ave #102
Fresno, CA 93711-3706
Phone
(559) 681-1947
Fax
(559) 860-0130
NPI assigned
Jan 9, 2009
Last updated
May 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2019

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

Authorized official

Name
Mr. Dale Dean White, CADCNPI 1639300239
Title
Executive Director
Phone
(559) 681-1947

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1204 W Shaw Ave #102
Fresno, CA 93711-3706

Mailing address

1204 W Shaw Ave #102
Fresno, CA 93711-3706
Phone (559) 681-1947

Other identifiers 1

IdentifierTypeStateIssuer
106364MedicaidCA

National Provider Directory

National Provider Directory

Locations

1204 W Shaw Ave
#102
Fresno, CA 93711
Phone (559) 273-2942

Practitioners & affiliated clinicians

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1231459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558569600000",
    "number": "1295972446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 W SHAW AVE #102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113706",
            "telephone_number": "559-681-1947",
            "fax_number": "559-860-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 W SHAW AVE #102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113706",
            "telephone_number": "559-681-1947",
            "fax_number": "559-860-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL CALIFORNIA RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-09",
        "last_updated": "2019-05-23",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "559-681-1947",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CADC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106364",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; 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.