NPIMap

Organization Active NPI

San Gabriel Recovery Ranch, LLC

  • Substance Abuse Rehabilitation Facility
  • Georgetown, TX
National Provider Identifier
1487955811
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
3338-3339 Issued in TX
Legal business name
SAN GABRIEL RECOVERY RANCH, LLC
Practice address
1443 County Road 103
Georgetown, TX 78626-3854
Phone
(512) 561-5086
Fax
(512) 692-2803
NPI assigned
Nov 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Authorized official

Name
Catherine S Oliver
Title
Controller
Phone
(512) 561-0586

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 3338-3339 TX 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) 561-5086

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

Other organizations with this tax ID 1

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

Locations

1443 County Road 103
Georgetown, TX 78626
Phone (512) 868-4952

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1487955811",
    "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": "512-561-5086",
            "fax_number": "512-692-2803"
        },
        {
            "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": "512-561-5086",
            "fax_number": "512-692-2803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN GABRIEL RECOVERY RANCH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-17",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "512-561-0586"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "TX",
            "license": "3338-3339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Arbor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "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 Jul 18, 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.