West Coast Wellness Centers LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

330133AP Issued in CA

Legal business name

WEST COAST WELLNESS CENTERS LLC

Doing business as

Wellness Counseling Vida Entera

Practice address

31631 Auto Center Dr
Lake Elsinore, CA 92530-4523

Phone

(623) 388-3353

NPI assigned

Aug 21, 2015

Organization subpart

Yes

Parent organization

SOCAL ADDICTION & TREATMENT COMPANY, LLCAs reported in NPPES

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

Authorized official

Name

Edward Rousseau

Title

Chief Administrative Officer

Phone

(772) 266-7682

Specialties & licenses 7

Addresses

Other names 1

• Wellness Counseling Vida Entera Doing business as

Locations

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

{
    "created_epoch": "1440115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541548800000",
    "number": "1326415613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31631 AUTO CENTER DR",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304523",
            "telephone_number": "623-388-3353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31631 AUTO CENTER DR",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304523",
            "telephone_number": "623-388-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COAST WELLNESS CENTERS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOCAL ADDICTION & TREATMENT COMPANY, LLC",
        "enumeration_date": "2015-08-21",
        "last_updated": "2018-11-07",
        "status": "A",
        "authorized_official_last_name": "ROUSSEAU",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "772-266-7682"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "330133AP",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "330133DP",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "330133BP",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "330133CP",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "330133FP",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "330133GP",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "330133HP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellness Counseling Vida Entera",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Substance Abuse Rehabilitation Facility in Lake Elsinore, CA
• Providers in Lake Elsinore, 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 Nov 7, 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.