United Recovery Centers

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

Legal business name

UNITED RECOVERY CENTERS

Practice address

17781 Hornbean Dr
Wildwood, MO 63005-4229

Phone

(760) 908-1253

NPI assigned

May 4, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Sarfaraz Abdeali Jasdanwala, MD

Title

Owner

Phone

(312) 953-5636

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620086400000",
    "number": "1629651971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17781 HORNBEAN DR",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630054229",
            "telephone_number": "760-908-1253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17781 HORNBEAN DR",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630054229",
            "telephone_number": "760-908-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED RECOVERY CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-04",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A",
        "authorized_official_last_name": "JASDANWALA",
        "authorized_official_first_name": "SARFARAZ",
        "authorized_official_middle_name": "ABDEALI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-953-5636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Wildwood, MO
• Addiction Medicine (Internal Medicine) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.