Cvrrc, MHS, Inc

Key facts

NPI

1649433236

Entity type

Organization (NPI type 2)

Primary specialty

Substance Abuse Rehabilitation Facility 324500000X

Legal business name

CVRRC, MHS, INC

Practice address

1076 Santo Antonio Dr
Colton, CA 92324-8103

Phone

(909) 433-9824

NPI assigned

Jul 3, 2008

Organization subpart

No

Authorized official

Name

Ron Stark, RRW, SAC

Title

Sac Counselor

Phone

(909) 433-9824

National Provider Directory

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 3, 2008.

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1649433236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 SANTO ANTONIO DR",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923248103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 SANTO ANTONIO DR",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923248103",
            "telephone_number": "909-433-9824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CVRRC, MHS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-03",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "SAC COUNSELOR",
        "authorized_official_telephone_number": "909-433-9824",
        "authorized_official_credential": "RRW, SAC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAADE",
            "identifier": "632008",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

• Mihail Cureteu
• Ashley Teya Curtis, MD
• Jeanne Emily Curtis
• Cusm Health
• Cvrrc MHS Inc.
• Amy Elizabeth Dahlberg, PA-C
• Darold Dahse
• Divina Dakanay
• Mary I Dallah, NP
• Katelyn Marie Dalton

All providers in Colton, CA · Substance Abuse Rehabilitation Facility in California