NPIMap

Organization Active NPI

Free at Last:Community Recovery and Rehabilitation Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • East Palo Alto, CA
National Provider Identifier
1679868715
Registry record updated Jun 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
410027IN Issued in CA
Legal business name
FREE AT LAST:COMMUNITY RECOVERY AND REHABILITATION SERVICES
Practice address
1796 Bay Rd
East Palo Alto, CA 94303-1611
Phone
(650) 462-6999
Fax
(650) 462-1055
NPI assigned
Jun 16, 2011
Last updated
Jun 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2011

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

Authorized official

Name
Mrs. Elizabeth Mendoza
Title
Administrator
Phone
(650) 462-6999

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 410027IN CA Primary
Substance Abuse Rehabilitation Facility 324500000X 410027AN CA
Substance Abuse Rehabilitation Facility 324500000X 410027LN CA
Substance Abuse Rehabilitation Facility 324500000X 410027BN CA

Addresses

Primary practice location

1796 Bay Rd
East Palo Alto, CA 94303-1611

Mailing address

1796 Bay Rd
East Palo Alto, CA 94303-1611
Phone (650) 462-6999

Other identifiers 1

IdentifierTypeStateIssuer
FREEATLAST11MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Free at Last Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1796 Bay Rd
East Palo Alto, CA 94303
Phone (650) 462-6980

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308182400000",
    "number": "1679868715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1796 BAY RD",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031611",
            "telephone_number": "650-462-6999",
            "fax_number": "650-462-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1796 BAY RD",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031611",
            "telephone_number": "650-462-6999",
            "fax_number": "650-462-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREE AT LAST:COMMUNITY RECOVERY AND REHABILITATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-16",
        "last_updated": "2011-06-16",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "650-462-6999",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CA",
            "license": "410027IN",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "410027AN",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "410027LN",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "410027BN",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FREEATLAST11",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2011; 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.