NPIMap

Organization Active NPI

Ascentions Treatment Center , LLC

Doing business as Rise at Mayberry

  • Substance Abuse Rehabilitation Facility
  • Simi Valley, CA
National Provider Identifier
1568206134
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
ASCENTIONS TREATMENT CENTER , LLC
Doing business as
Rise at Mayberry
Practice address
1950 Rocking Horse Dr
Simi Valley, CA 93065-5906
Phone
(805) 386-7671
NPI assigned
Jun 19, 2024
Organization subpart
Yes
Parent organization
ASCENTIONS TREATMENT CENTER, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Authorized official

Name
Dr. Kimberly Martin, PSY.D.NPI 1134982770
Title
Compliance Officer
Phone
(805) 813-1659

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

1950 Rocking Horse Dr
Simi Valley, CA 93065-5906

Mailing address

PO Box 2337
Agoura Hills, CA 91376-2337

Other practice location 1

1939 Rambling Rd
Simi Valley, CA 93065-5934
Phone (805) 386-7671

Other names 1

  • Rise at Mayberry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ascentions Treatment Center LLC2 organizations share this tax ID, including this one
Part of
Ascentions Treatment Center LLC

Other organizations with this tax ID 1

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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718755200000",
    "number": "1568206134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2337",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913762337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 ROCKING HORSE DR",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930655906",
            "telephone_number": "805-386-7671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1939 Rambling Rd",
            "address_purpose": "LOCATION",
            "city": "Simi Valley",
            "state": "CA",
            "postal_code": "930655934",
            "country_code": "US",
            "telephone_number": "805-386-7671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ASCENTIONS TREATMENT CENTER , LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ASCENTIONS TREATMENT CENTER, LLC",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "805-813-1659",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rise at Mayberry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.