Recovery Boulevard LLC

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

P0907070941 Issued in CA

Legal business name

RECOVERY BOULEVARD LLC

Practice address

17011 Beach Blvd Ste 900
Huntington Beach, CA 92647-5998

Phone

(714) 375-6626

NPI assigned

May 26, 2017

Organization subpart

No

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

Authorized official

Name

Mike Priesing, MHW CATC

Title

Ceo

Phone

(949) 300-1657

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1495756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1306374970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17011 BEACH BLVD STE 900",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926475998",
            "telephone_number": "714-375-6626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17011 BEACH BLVD STE 900",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926475998",
            "telephone_number": "714-375-6626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECOVERY BOULEVARD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PRIESING",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-300-1657",
        "authorized_official_credential": "MHW CATC"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "P0907070941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Manager/Care Coordinator in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.