The Runway of California, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

THE RUNWAY OF CALIFORNIA, LLC

Practice address

1245 W Chestnut Ave
Santa Ana, CA 92703-4535

Phone

(714) 299-1729

Fax

(657) 210-4439

NPI assigned

Jul 31, 2023

Organization subpart

No

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

Authorized official

Name

Ms. Lisa Michelle Osendorf, C052570518

Title

Program Director

Phone

(714) 299-1729

Specialties & licenses 1

Addresses

Other names 1

• The Runway Recovery Other name

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690761600000",
    "number": "1477234516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 W CHESTNUT AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927034535",
            "telephone_number": "714-299-1729",
            "fax_number": "657-210-4439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 W CHESTNUT AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927034535",
            "telephone_number": "714-299-1729",
            "fax_number": "657-210-4439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE RUNWAY OF CALIFORNIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A",
        "authorized_official_last_name": "OSENDORF",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "714-299-1729",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "C052570518"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Runway Recovery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Substance Abuse Rehabilitation Facility in Santa Ana, CA
• Providers in Santa Ana, 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 Jul 31, 2023; 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.