NPIMap

Organization Active NPI

Executive Recovery Group, Inc

  • Substance Abuse Rehabilitation Facility
  • Palm Desert, CA
National Provider Identifier
1497411748
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
EXECUTIVE RECOVERY GROUP, INC
Doing business as
Phoenix Rising Recovery
Practice address
35450 Pegasus CT Ste B
Palm Desert, CA 92211-1604
Phone
(760) 200-3839
NPI assigned
Nov 11, 2021
Organization subpart
Yes
Parent organization
EXECUTIVE RECOVERY GROUP, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Authorized official

Name
Amy Crichton
Title
Executive Director
Phone
(760) 200-3839

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

35450 Pegasus CT Ste B
Palm Desert, CA 92211-1604

Mailing address

35450 Pegasus CT
Palm Desert, CA 92211-1604

Other names 1

  • Phoenix Rising Recovery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Executive Recovery Group Inc9 organizations share this tax ID, including this one
Part of
Executive Recovery Group Inc

Other organizations with this tax ID 8

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

Locations

35450 Pegasus Ct
Ste B
Palm Desert, CA 92211
Phone (760) 200-3839

NPI Registry JSON

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

{
    "created_epoch": "1636588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636588800000",
    "number": "1497411748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35450 PEGASUS CT",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922111604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35450 PEGASUS CT STE B",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922111604",
            "telephone_number": "760-200-3839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE RECOVERY GROUP, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXECUTIVE RECOVERY GROUP, INC",
        "enumeration_date": "2021-11-11",
        "last_updated": "2021-11-11",
        "certification_date": "2021-10-27",
        "status": "A",
        "authorized_official_last_name": "CRICHTON",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "760-200-3839"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Rising Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palm Desert, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.