NPIMap

Organization Active NPI

New Life Spirit Recovery, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Huntington Beach, CA
National Provider Identifier
1508130808
Registry record updated Jan 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
300190AP Issued in CA
Legal business name
NEW LIFE SPIRIT RECOVERY, INC.
Practice address
18652 Florida St
Suite 200
Huntington Beach, CA 92648-1924
Phone
(714) 841-1906
Fax
(714) 908-3308
NPI assigned
Mar 4, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2014

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

Authorized official

Name
Robert Tucker, MCA, MRAS, MDAACNPI 1518491620
Title
Ceo
Phone
(714) 841-1906

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X 300190AP CA
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 300190AP CA Primary

Addresses

Primary practice location

18652 Florida St
Suite 200
Huntington Beach, CA 92648-1924

Mailing address

18652 Florida St
Suite 200
Huntington Beach, CA 92648-1924
Phone (714) 841-1906

Other identifiers 1

IdentifierTypeStateIssuer
300190APOtherCADHCS - DEPARTMENT OF HEALTH CARE SERVICES

National Provider Directory

National Provider Directory

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": "1330819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390176000000",
    "number": "1508130808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18652 FLORIDA ST",
            "address_2": "SUITE 200",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926481924",
            "telephone_number": "714-841-1906",
            "fax_number": "714-908-3308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18652 FLORIDA ST",
            "address_2": "SUITE 200",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926481924",
            "telephone_number": "714-841-1906",
            "fax_number": "714-908-3308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE SPIRIT RECOVERY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-04",
        "last_updated": "2014-01-20",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-841-1906",
        "authorized_official_credential": "MCA, MRAS, MDAAC"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "CA",
            "license": "300190AP",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CA",
            "license": "300190AP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHCS - DEPARTMENT OF HEALTH CARE SERVICES",
            "identifier": "300190AP",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2014; 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.