NPIMap

Organization Active NPI

Sobertec LLC

  • Substance Abuse Rehabilitation Facility
  • San Juan Capistrano, CA
National Provider Identifier
1578070587
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
300254HP Issued in CA
Legal business name
SOBERTEC LLC
Practice address
33801 Via Cascada
San Juan Capistrano, CA 92675-5037
Phone
(949) 498-4321
NPI assigned
Dec 29, 2017
Organization subpart
Yes
Parent organization
SOBERTEC LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Authorized official

Name
Darryle Mackelvey
Title
Supervisor
Phone
(714) 948-6086

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 300254HP CA Primary

Addresses

Primary practice location

33801 Via Cascada
San Juan Capistrano, CA 92675-5037

Mailing address

PO Box 511544
Los Angeles, CA 90051-8099

National Provider Directory

National Provider Directory
Tax ID family
Sobertec LLC7 organizations share this tax ID, including this one
Part of
Sobertec LLC

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1514505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576627200000",
    "number": "1578070587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 511544",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900518099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33801 VIA CASCADA",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926755037",
            "telephone_number": "949-498-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOBERTEC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOBERTEC LLC",
        "enumeration_date": "2017-12-29",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A",
        "authorized_official_last_name": "MACKELVEY",
        "authorized_official_first_name": "DARRYLE",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "714-948-6086"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "300254HP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan Capistrano, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; 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.