Narconon Fresh Start

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

3000077AN; 370087AN Issued in CA

Legal business name

NARCONON FRESH START

Practice address

17123 Roundhill Drive
Huntington Beach, CA 92649

Phone

(323) 871-8644

Fax

(818) 500-0542

NPI assigned

Oct 25, 2006

Organization subpart

No

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

Authorized official

Name

Shannon Farnsworth

Title

VP Administration

Phone

(323) 871-8644

Specialties & licenses 1

Addresses

Other names 1

• Narconon Southern California Former legal business name

Locations

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337212800000",
    "number": "1336223296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 W BROADWAY",
            "address_2": "SUITE 420",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041331",
            "telephone_number": "323-871-8644",
            "fax_number": "818-500-0542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17123 ROUNDHILL DRIVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "92649",
            "telephone_number": "323-871-8644",
            "fax_number": "818-500-0542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NARCONON FRESH START",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2012-05-17",
        "status": "A",
        "authorized_official_last_name": "FARNSWORTH",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "VP ADMINISTRATION",
        "authorized_official_telephone_number": "323-871-8644"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "3000077AN; 370087AN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Narconon Southern California",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Substance Abuse Rehabilitation Facility in Huntington Beach, CA
• Providers in Huntington Beach, 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 May 17, 2012; 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.