Pura Vida Recovery Services, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

PURA VIDA RECOVERY SERVICES, LLC

Practice address

130 Stony Point Rd
Santa Rosa, CA 95401-4120

Phone

(707) 338-5927

NPI assigned

Jan 10, 2017

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

Cao

Phone

(707) 338-5927

Specialties & licenses 1

Addresses

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": "1484006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605571200000",
    "number": "1346786696",
    "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": "707-338-5927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 STONY POINT RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014120",
            "telephone_number": "707-338-5927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURA VIDA RECOVERY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-10",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A",
        "authorized_official_last_name": "PAHLAVAN",
        "authorized_official_first_name": "BEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "707-338-5927"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 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)
• Pura Vida Recovery Services, LLC
• Pura Vida Recovery Services, LLC (Pura Vida Recovery Services)
• Parwinder Purewal
• Sukhpreet Kaur Purewal, PHARMD
• Alexis Renee Purugganan

• Substance Use Disorder Rehabilitation Clinic/Center in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.