Fountain Recovery

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

010095AP Issued in CA

Legal business name

FOUNTAIN RECOVERY

Practice address

4049 1St St Ste 123
Livermore, CA 94551-4949

Phone

(925) 292-5583

NPI assigned

Jul 8, 2009

Organization subpart

Yes

Parent organization

BROTHER AND SISTER PARTNERSHIPAs reported in NPPES

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

Authorized official

Name

Natasha Archuleta

Title

Owner

Phone

(925) 292-5583

Specialties & licenses 1

Addresses

Part of

Fountain Recovery

Locations

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519257600000",
    "number": "1497984744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4049 1ST ST STE 123",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945514949",
            "telephone_number": "925-292-5583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4049 1ST ST STE 123",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945514949",
            "telephone_number": "925-292-5583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN RECOVERY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROTHER AND SISTER PARTNERSHIP",
        "enumeration_date": "2009-07-08",
        "last_updated": "2018-02-22",
        "status": "A",
        "authorized_official_last_name": "ARCHULETA",
        "authorized_official_first_name": "NATASHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "925-292-5583"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "010095AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Livermore, CA
• Providers in Livermore, 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 Feb 22, 2018; 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.