NPIMap

Organization Active NPI

My Time Recovery, LLC

  • Substance Abuse Rehabilitation Facility
  • Fresno, CA
National Provider Identifier
1518713643
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
MY TIME RECOVERY, LLC
Practice address
5236 N Bryn Mawr Dr
Fresno, CA 93711-2808
Phone
(559) 840-0896
Fax
(559) 282-3102
NPI assigned
Apr 29, 2024
Organization subpart
Yes
Parent organization
MY TIME RECOVERY, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Authorized official

Name
Scott Sample
Title
Owner
Phone
(559) 392-0241

Specialties & licenses 1

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

Addresses

Primary practice location

5236 N Bryn Mawr Dr
Fresno, CA 93711-2808

Mailing address

83 E Shaw Ave Ste 200
Fresno, CA 93710-7624
Phone (559) 840-0896

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2301247My Time Recovery LLC5236 N Bryn Mawr Dr, Fresno, CA 93711Certificate of waiverMar 21, 2028

National Provider Directory

National Provider Directory
Tax ID family
My Time Recovery LLC6 organizations share this tax ID, including this one
Part of
My Time Recovery LLC

Other organizations with this tax ID 5

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1518713643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 E SHAW AVE STE 200",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937107624",
            "telephone_number": "559-840-0896",
            "fax_number": "559-282-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5236 N BRYN MAWR DR",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937112808",
            "telephone_number": "559-840-0896",
            "fax_number": "559-282-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY TIME RECOVERY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MY TIME RECOVERY, LLC",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "SAMPLE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "559-392-0241"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.