Rancho Recovery LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

RANCHO RECOVERY LLC

Practice address

13684 Jeremy CT
Rancho Cucamonga, CA 91739-2031

Phone

(909) 476-2023

Fax

(909) 697-2900

NPI assigned

Jun 12, 2023

Organization subpart

No

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

Authorized official

Name

Samuel Phillips

Title

Controller

Phone

(909) 292-6827

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 4

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

• Margianne Isaia, CLINICAL COUNSELING

  • Professional Counselor
  • Rancho Cucamonga, CA
  • NPI 1083044275
  NPD
• Kenneth Fillmore

  • Addiction (Substance Use Disorder) Counselor
  • Rancho Cucamonga, CA
  • NPI 1164357885
  NPD (past)
• Julian Garcia, CADC-I

  • Addiction (Substance Use Disorder) Counselor
  • Claremont, CA
  • NPI 1790599066
  NPD (past)
• Diontre Johnson

  • Addiction (Substance Use Disorder) Counselor
  • Rancho Cucamonga, CA
  • NPI 1952253031
  NPD (past)

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1700560695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E ARROW HWY UNIT 220",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917857008",
            "telephone_number": "909-476-2023",
            "fax_number": "909-697-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13684 JEREMY CT",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917392031",
            "telephone_number": "909-476-2023",
            "fax_number": "909-697-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANCHO RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "909-292-6827"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rancho Heart Institute
• Rancho Outpatient Surgical Center, LLC.
• Rancho Pediatric Associates
• Rancho Physical Therapy, Inc.
• Rancho Primary Care Clinic, a Nursing Professional Corporation
• Rancho Surgical Institute LLC
• Rancho Urgent Care Phcy
• Rancho Vision Center Optometry Inc
• Rancho Wound Care Center, PC
• Jackson Rand

• Substance Abuse Rehabilitation Facility in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, 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 Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.