Bluestone Recovery, Inc.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

330127AP Issued in CA

Legal business name

BLUESTONE RECOVERY, INC.

Practice address

1660 Chicago Ave Ste M11
Riverside, CA 92507-2033

Phone

(951) 823-0540

Fax

(951) 823-0541

NPI assigned

Aug 20, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Michael J Lyons, LAADAC

Title

Ceo

Phone

(951) 536-2213

Specialties & licenses 3

Addresses

Tax ID family

Bluestone Recovery Inc2 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.

• Bluestone Recovery, Inc.

  • Substance Abuse Rehabilitation Facility
  • Riverside, CA
  • NPI 1902345705
  NPD tax ID

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

{
    "created_epoch": "1408492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474329600000",
    "number": "1578962114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 CHICAGO AVE STE M11",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072033",
            "telephone_number": "951-823-0540",
            "fax_number": "951-823-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 CHICAGO AVE STE M11",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072033",
            "telephone_number": "951-823-0540",
            "fax_number": "951-823-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUESTONE RECOVERY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-20",
        "last_updated": "2016-09-20",
        "status": "A",
        "authorized_official_last_name": "LYONS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-536-2213",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LAADAC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "330127AP",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CA",
            "license": "330127AP",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "360107BP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blissful Jackson Facility LLC
• Clarisa Marie Bloemhof
• Katelynn Christine Bloom
• Lakemie Catricia Blount
• Lindsay Joy Blount, COTA/L
• Bluestone Recovery, Inc.
• Rhoda K. Blum, MD
• Mary Louise Blunt III
• Charles Boadu, MD
• Abigail Kirby Akua Boaitey

• Substance Use Disorder Rehabilitation Clinic/Center in Riverside, CA
• Providers in Riverside, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; 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.