Chronicles of Success Recovery Services LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

CHRONICLES OF SUCCESS RECOVERY SERVICES LLC

Practice address

3140 Juanipero Way Ste 101
Medford, OR 97504-8647

Phone

(541) 508-0336

Fax

(541) 508-0330

NPI assigned

Aug 26, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Donique BoazemanNPI 1528955622

Title

Owner/Administrator

Phone

(313) 977-2767

Specialties & licenses 6

Addresses

Tax ID family

Chronicles of Success Recovery Services LLC2 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.

• Chronicles of Success Recovery Services LLC

  • Addiction (Substance Use Disorder) Counselor
  • Medford, OR
  • NPI 1104765825
  NPD tax ID

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Donique Boazeman

  • Case Manager/Care Coordinator
  • Medford, OR
  • NPI 1528955622

  Case Management

  NPD Authorized official
• Chloe Burtz

  • Community Health Worker
  • Medford, OR
  • NPI 1043100274

  Case Management

  NPD
• Dionte Davis

  • Health & Wellness Coach
  • Medford, OR
  • NPI 1194613984
  NPD
• Marlon Davis

  • Community Health Worker
  • Medford, OR
  • NPI 1497643282
  NPD
• Mason Howell

  • Community Health Worker
  • Medford, OR
  • NPI 1518857754

  Case Management

  NPD

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748908800000",
    "number": "1629801543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5441 S MACADAM AVE STE N",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396106",
            "telephone_number": "866-674-3347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3140 JUANIPERO WAY STE 101",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048647",
            "telephone_number": "541-508-0336",
            "fax_number": "541-508-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRONICLES OF SUCCESS RECOVERY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-26",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A",
        "authorized_official_last_name": "BOAZEMAN",
        "authorized_official_first_name": "DONIQUE",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "313-977-2767",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Lynn Christian, PHARM.D.
• Mattea Christianson
• Christina M Christopher
• Nicole Deanne Christy
• Chronicles of Success Recovery Services LLC
• Kelly Chuang
• Daniel Chung
• Kelly Eileen Church, FNP
• Todd Christopher Churchill, OTR/L
• Gregory King Churlik

• Mental Health Clinic/Center (Including Community Mental Health Center) in Medford, OR
• Providers in Medford, OR by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; 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.