Pain Recovery Medical Group

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

G45144 Issued in CA

Legal business name

PAIN RECOVERY MEDICAL GROUP

Doing business as

Tres Vistas Recovery

Practice address

32301 Camino Capistrano Ste K&L
San Juan Capistrano, CA 92675-4512

Phone

(949) 533-3046

NPI assigned

May 16, 2015

Last updated

Jan 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Villarreal

Title

President

Phone

(949) 533-3046

Specialties & licenses 1

Addresses

Other names 1

• TRES VISTAS RECOVERY Doing business as

Tax ID family

Headrick Integrative Healing2 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.

• Pain Recovery Medical Group, Inc

  dba Headrick Integrative Healing

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Dana Point, CA
  • NPI 1841683984
  NPD tax ID

Locations

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

{
    "created_epoch": "1431734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673481600000",
    "number": "1528446044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32301 CAMINO CAPISTRANO STE K&L",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926754512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32301 CAMINO CAPISTRANO STE K&L",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926754512",
            "telephone_number": "949-533-3046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "243 Avenida La Cuesta",
            "address_purpose": "LOCATION",
            "city": "San Clemente",
            "state": "CA",
            "postal_code": "926722140",
            "country_code": "US",
            "telephone_number": "844-900-0444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PAIN RECOVERY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-16",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A",
        "authorized_official_last_name": "VILLARREAL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-533-3046"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "G45144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TRES VISTAS RECOVERY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TRES VISTAS RECOVERY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Substance Abuse Rehabilitation Facility in San Juan Capistrano, CA
• Providers in San Juan Capistrano, 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 Jan 12, 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.