North Bay Recovery Center, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

NORTH BAY RECOVERY CENTER, LLC

Practice address

55 Shaver St
San Rafael, CA 94901-2787

Phone

(415) 454-4357

Fax

(415) 454-4329

NPI assigned

Nov 19, 2012

Organization subpart

No

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

Authorized official

Name

Tyler Knight

Title

Ceo

Phone

(415) 454-4357

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380153600000",
    "number": "1669716361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 SHAVER ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012787",
            "telephone_number": "415-454-4357",
            "fax_number": "415-454-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SHAVER ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012787",
            "telephone_number": "415-454-4357",
            "fax_number": "415-454-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BAY RECOVERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-19",
        "last_updated": "2013-09-26",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "415-454-4357"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Herbert Perry Norman Jr., RAS
• Carol Normandi, MS, LMFT
• Shelley Beth Norris-Alvarez
• Marsha Ann Norris, LMFT
• Jennifer Norstrom, LMFT
• North Coast Medical Supply
• Northcoast Mobility
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• Northgate Care Center, Inc.
• Northgate Postacute Care

• Substance Abuse Rehabilitation Facility in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; 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.