Pasadena Recovery Center

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

190250AP Issued in CA

Legal business name

PASADENA RECOVERY CENTER

Practice address

1811 N Raymond Avenue
Pasadena, CA 91103-1840

Phone

(626) 345-9992

Fax

(626) 345-9995

NPI assigned

Dec 29, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Innocent Madu Onyeka, CAS

Title

Director

Phone

(626) 345-9992

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417013970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 N RAYMOND AVENUE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031840",
            "telephone_number": "626-345-9992",
            "fax_number": "626-345-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 N RAYMOND AVENUE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031840",
            "telephone_number": "626-345-9992",
            "fax_number": "626-345-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASADENA RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ONYEKA",
        "authorized_official_first_name": "INNOCENT",
        "authorized_official_middle_name": "MADU",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "626-345-9992",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CAS"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190250AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.