A Wildwood Recovery Iop

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

560040BP Issued in CA

Legal business name

A WILDWOOD RECOVERY IOP

Practice address

166 N. Moorpark Rd
Suite 304
Thousand Oaks, CA 91360

Phone

(805) 497-1900

Fax

(805) 497-1920

NPI assigned

Jul 19, 2018

Last updated

Jul 19, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

A WILDWOOD RECOVERYAs reported in NPPES

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

Authorized official

Name

Ms. Shannon Siaotong

Title

Facility Administrator

Phone

(805) 493-5741

Specialties & licenses 1

Addresses

Tax ID family

A Wildwood Recovery2 organizations share this tax ID, including this one

Part of

A Wildwood Recovery

Other organizations with this tax ID 1

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

• A Wildwood Recovery

  • Substance Abuse Rehabilitation Facility
  • Thousand Oaks, CA
  • NPI 1144517723
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• A Wildwood Recovery

  • Substance Abuse Rehabilitation Facility
  • Thousand Oaks, CA
  • NPI 1144517723
  NPPES parent name

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1306323639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 N. MOORPARK RD",
            "address_2": "SUITE 304",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "91360",
            "telephone_number": "805-497-1900",
            "fax_number": "805-497-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 N. MOORPARK RD",
            "address_2": "SUITE 304",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "91360",
            "telephone_number": "805-497-1900",
            "fax_number": "805-497-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A WILDWOOD RECOVERY IOP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "A WILDWOOD RECOVERY",
        "enumeration_date": "2018-07-19",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "SIAOTONG",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "FACILITY ADMINISTRATOR",
        "authorized_official_telephone_number": "805-493-5741",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CA",
            "license": "560040BP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 911 Biocare
• A Better Care Hospice, Inc.
• A Kwan Acupuncture (Acuhope Center)
• A New Start Recovery Center, LLC
• A Wildwood Recovery
• Venkat Raghav Aachi, MD
• Azadeh Juliet Aarons, LMFT
• Sandra Abadir, MD
• Hazel Abaya
• Siddique Abbasi, MD

• Substance Use Disorder Rehabilitation Clinic/Center in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.