Experience Recovery Detox & Residential LLC.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

EXPERIENCE RECOVERY DETOX & RESIDENTIAL LLC.

Practice address

3921 W Hazard Ave
Santa Ana, CA 92703-2625

Phone

(800) 970-3973

Fax

(855) 275-5428

NPI assigned

Aug 17, 2018

Organization subpart

No

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

Authorized official

Name

James Sewell

Title

Ceo, JDS Consuting, Inc

Phone

(402) 250-8989

Specialties & licenses 1

Addresses

Tax ID family

Experience Recovery Detox Residential LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Experience Recovery Detox & Residential LLC.

  • Substance Abuse Rehabilitation Facility
  • Santa Ana, CA
  • NPI 1194250258
  NPD tax ID

Locations

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733097600000",
    "number": "1316427446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3919 W HAZARD AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927032625",
            "telephone_number": "800-870-3973",
            "fax_number": "855-275-5428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 W HAZARD AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927032625",
            "telephone_number": "800-970-3973",
            "fax_number": "855-275-5428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPERIENCE RECOVERY DETOX & RESIDENTIAL LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-17",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A",
        "authorized_official_last_name": "SEWELL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO, JDS CONSUTING, INC",
        "authorized_official_telephone_number": "402-250-8989"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evernorth Direct Health LLC
• Lynette Dee Ewing, PSYCHIATRIC TECH.
• Tanji Ewing, MA, LMFT
• Executive Hand Therapy, Inc.
• Experience Recovery Detox & Residential LLC.
• Expresss Medz Inc
• Eyecare Specialists Medical Group, Inc.
• Eyeschoice Optometry
• Ez Meds, LLC
• Julie Teri Ezaki, PTA

• Substance Abuse Rehabilitation Facility in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.