Life Vessel Treatment and Recovery

Primary specialty

Substance Use Disorder Rehabilitation Hospital UnitTaxonomy code 276400000X

License

300683AP Issued in CA

Legal business name

LIFE VESSEL TREATMENT AND RECOVERY

Practice address

25466 Gloriosa Dr
Mission Viejo, CA 92691-4642

Phone

(949) 388-4114

NPI assigned

Dec 26, 2017

Organization subpart

No

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

Authorized official

Name

Cesar B Cabrera, PHARM DNPI 1790404036

Title

Executive Director

Phone

(949) 388-4114

Specialties & licenses 1

Addresses

Other names 1

• The Mission House Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cesar Burguillos Cabrera, CATC V

  • Addiction (Substance Use Disorder) Counselor
  • Mission Viejo, CA
  • NPI 1790404036
  NPD Authorized official
• Michael F Bishara, M.D.

  • Addiction Medicine (Internal Medicine) Physician
  • Riverside, CA
  • NPI 1144311044
  NPD (past)

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

{
    "created_epoch": "1514246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547769600000",
    "number": "1467968677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 W 17TH ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926274503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25466 GLORIOSA DR",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926914642",
            "telephone_number": "949-388-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE VESSEL TREATMENT AND RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-26",
        "last_updated": "2019-01-18",
        "status": "A",
        "authorized_official_last_name": "CABRERA",
        "authorized_official_first_name": "CESAR",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "949-388-4114",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "CA",
            "license": "300683AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Mission House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ming Charles Li, MD
• Jenny L Liang, D.M.D
• Shannon Lauren Liauw, FNP-C
• Stacy Libenson
• Joshua Jordan Licitra
• Life Vessel Treatment and Recovery Driza, LLC
• Andrew Lin, PT
• Andrew Ta Lin, LVN
• Angela Shiaoyuan Lin
• Christopher B. Lin, M. D.

• Substance Use Disorder Rehabilitation Hospital Unit in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Substance Use Disorder Rehabilitation Hospital Unit in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.