NPIMap

Organization Active NPI

San Gabriel Recovery Ranch LLC

  • Substance Abuse Rehabilitation Facility
  • Georgetown, TX
National Provider Identifier
1386300770
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
SAN GABRIEL RECOVERY RANCH LLC
Practice address
1443 County Road 103
Georgetown, TX 78626-3854
Phone
(512) 840-9167
Fax
(512) 430-1394
NPI assigned
Nov 10, 2021
Organization subpart
Yes
Parent organization
SAN GABRIEL RECOVERY RANCH LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Authorized official

Name
Valerie A Anderson
Title
Billing & Collections Specialist
Phone
(512) 840-9167

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TA0400X
Psychiatric Hospital Unit 273R00000X
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

1443 County Road 103
Georgetown, TX 78626-3854

Mailing address

1443 County Road 103
Georgetown, TX 78626-3854
Phone (512) 840-9167

Other names 1

  • The Arbor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
San Gabriel Recovery Ranch LLC2 organizations share this tax ID, including this one
Part of
San Gabriel Recovery Ranch LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636588800000",
    "number": "1386300770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1443 COUNTY ROAD 103",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786263854",
            "telephone_number": "512-840-9167",
            "fax_number": "512-430-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1443 COUNTY ROAD 103",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786263854",
            "telephone_number": "512-840-9167",
            "fax_number": "512-430-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN GABRIEL RECOVERY RANCH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAN GABRIEL RECOVERY RANCH LLC",
        "enumeration_date": "2021-11-10",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BILLING & COLLECTIONS SPECIALIST",
        "authorized_official_telephone_number": "512-840-9167"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Arbor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.