417 Orange County LLC

Primary specialty

Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X

Legal business name

417 ORANGE COUNTY LLC

Doing business as

417 Recovery

Practice address

26010 Acero Ste 200
Mission Viejo, CA 92691-2768

Phone

(760) 485-6563

NPI assigned

Dec 5, 2023

Last updated

Dec 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stevie Kuhn

Title

Cfo

Phone

(760) 485-6563

Specialties & licenses 3

Addresses

Other names 1

• 417 Recovery Doing business as

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

{
    "created_epoch": "1701734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1649047242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595 GRAND AVE STE 102",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782450",
            "telephone_number": "760-485-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26010 ACERO STE 200",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926912768",
            "telephone_number": "760-485-6563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "417 ORANGE COUNTY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-05",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A",
        "authorized_official_last_name": "KUHN",
        "authorized_official_first_name": "STEVIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "760-485-6563"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "417 Recovery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "417 Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Children's Substance Abuse Rehabilitation Facility in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Children's Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.