Southern California Recovery Centers Oceanside LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

370158AP Issued in CA

Legal business name

SOUTHERN CALIFORNIA RECOVERY CENTERS OCEANSIDE LLC

Practice address

2850 Pio Pico Dr Ste a-D
Carlsbad, CA 92008-1554

Phone

(760) 517-1758

Fax

(949) 542-3878

NPI assigned

Dec 5, 2017

Organization subpart

No

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

Authorized official

Name

Douglas Penny

Title

Manager

Phone

(949) 481-6156

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553126400000",
    "number": "1386159945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 PIO PICO DR STE A-D",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 PIO PICO DR STE A-D",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081554",
            "telephone_number": "760-517-1758",
            "fax_number": "949-542-3878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA RECOVERY CENTERS OCEANSIDE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-05",
        "last_updated": "2019-03-21",
        "status": "A",
        "authorized_official_last_name": "PENNY",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "949-481-6156"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CA",
            "license": "370158AP",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D2146685",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA",
            "identifier": "CDF00352100",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA",
            "identifier": "370158AP",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Carlsbad, CA
• Providers in Carlsbad, 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 Mar 21, 2019; 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.