Pura Vida Recovery Services, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

PURA VIDA RECOVERY SERVICES, LLC

Doing business as

Pura Vida Recovery Services

Practice address

1506 Ronne Dr
Santa Rosa, CA 95404-5705

Phone

(707) 879-8432

Fax

(844) 426-0134

NPI assigned

Aug 28, 2023

Organization subpart

No

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

Authorized official

Name

Ben A Pahlavan

Title

Chief Administrative Officer

Phone

(707) 879-8432

Specialties & licenses 1

Addresses

Other names 1

• Pura Vida Recovery Services Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roderick W Fontenette, MD

  • Emergency Medicine Physician
  • Travis AFB, CA
  • NPI 1164672499
  NPD
• Katherine J Schwimmer

  • Clinical Psychologist
  • Sebastopol, CA
  • NPI 1578843801
  NPD

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1346025343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 STONY POINT RD STE J",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014120",
            "telephone_number": "707-879-8432",
            "fax_number": "844-426-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 RONNE DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954045705",
            "telephone_number": "707-879-8432",
            "fax_number": "844-426-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURA VIDA RECOVERY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "PAHLAVAN",
        "authorized_official_first_name": "BEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "707-879-8432"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pura Vida Recovery Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• George James Pulis, M.A.
• Keith Lauren Pullin, P.T., D.P.T.
• Harendra Keshavlal Punatar, M.D.
• Pura Vida Recovery Services, LLC (Pura Vida Recovery Services)
• Pura Vida Recovery Services, LLC (Pura Vida Recovery Services)
• Pura Vida Recovery Services, LLC
• Pura Vida Recovery Services, LLC
• Pura Vida Recovery Services, LLC (Pura Vida Recovery Services)
• Parwinder Purewal
• Sukhpreet Kaur Purewal, PHARMD

• Substance Abuse Rehabilitation Facility in Santa Rosa, CA
• Providers in Santa Rosa, 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 Aug 28, 2023; 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.