NPIMap

Organization Active NPI

The Eternity Challenge

  • Substance Abuse Rehabilitation Facility
  • Rocklin, CA
National Provider Identifier
1386004398
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
THE ETERNITY CHALLENGE
Practice address
4200 Rocklin Rd Ste 1
Rocklin, CA 95677-2860
Phone
(916) 624-4428
NPI assigned
Mar 3, 2016
Last updated
Mar 3, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Authorized official

Name
Robert Beaudry
Title
Ceo
Phone
(916) 716-5029

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

4200 Rocklin Rd Ste 1
Rocklin, CA 95677-2860

Mailing address

4200 Rocklin Rd Ste 1
Rocklin, CA 95677-2860
Phone (916) 624-4428

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456963200000",
    "number": "1386004398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 ROCKLIN RD STE 1",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956772860",
            "telephone_number": "916-624-4428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 ROCKLIN RD STE 1",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956772860",
            "telephone_number": "916-624-4428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ETERNITY CHALLENGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-03",
        "last_updated": "2016-03-03",
        "status": "A",
        "authorized_official_last_name": "BEAUDRY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-716-5029"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocklin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.