NPIMap

Organization Active NPI

Crest Recovery LLC

  • Substance Abuse Rehabilitation Facility
  • Mission Viejo, CA
National Provider Identifier
1316402225
Registry record updated Apr 8, 2020
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Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
CREST RECOVERY LLC
Doing business as
TruVida Recovery
Practice address
26886 Pueblonuevo Dr
Mission Viejo, CA 92691-4410
Phone
(949) 283-4679
NPI assigned
Feb 5, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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

Authorized official

Name
Ceaira Coffin
Title
Billing Director
Phone
(833) 233-0091

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

26886 Pueblonuevo Dr
Mission Viejo, CA 92691-4410

Mailing address

23726 Birtcher Dr
Lake Forest, CA 92630-1771
Phone (949) 283-4679

Other identifiers 1

IdentifierTypeStateIssuer
300351EPOtherCADHCS

Other names 1

  • TruVida Recovery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Crest Recovery LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586304000000",
    "number": "1316402225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23726 BIRTCHER DR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301771",
            "telephone_number": "949-283-4679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26886 PUEBLONUEVO DR",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926914410",
            "telephone_number": "949-283-4679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREST RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-05",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A",
        "authorized_official_last_name": "COFFIN",
        "authorized_official_first_name": "CEAIRA",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "833-233-0091"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHCS",
            "identifier": "300351EP",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TruVida Recovery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TruVida Recovery",
            "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 Apr 8, 2020; 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.