T & D Recovery Services, Inc.

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

T & D RECOVERY SERVICES, INC.

Practice address

24432 Muirlands Blvd Ste 223
Lake Forest, CA 92630-3951

Phone

(949) 606-4681

NPI assigned

Oct 30, 2018

Organization subpart

No

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

Authorized official

Name

Tyler Michaelis

Title

Ceo

Phone

(949) 606-4681

Specialties & licenses 2

Addresses

Other names 1

• OC Revive Wellness Doing business as

Locations

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540857600000",
    "number": "1396212262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24432 MUIRLANDS BLVD STE 223",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926303951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24432 MUIRLANDS BLVD STE 223",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926303951",
            "telephone_number": "949-606-4681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T & D RECOVERY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-30",
        "last_updated": "2018-10-30",
        "status": "A",
        "authorized_official_last_name": "MICHAELIS",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-606-4681"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OC Revive Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shannon Anna-Marie Swanson, MA, LMFT
• Chabonik Sweet, M.S., CCC-SLP
• Sylvain Pharmacy Inc.
• Synergy Behavioral Inc.
• Douglas S Szeto, D.M.D.
• T. D. Nguyen, D.D.S., Inc.
• Dina Tabibzada
• Karen Ann Tafreshi, D.C.
• Philip Tagatac, DMD
• Mohammad Reza Taghavi, DDS

• Adolescent and Children Mental Health Clinic/Center in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Adolescent and Children Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; 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.