NPIMap

Organization Active NPI

Recovery Bay Rehabilitation Center

Doing business as Path to Serenity

  • Substance Abuse Rehabilitation Facility
  • Villa Park, CA
National Provider Identifier
1710411483
Registry record updated Apr 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
300300BP Issued in CA
Legal business name
RECOVERY BAY REHABILITATION CENTER
Doing business as
Path to Serenity
Practice address
10002 Briley Way
Villa Park, CA 92861-4219
Phone
(949) 887-6379
NPI assigned
Apr 19, 2017
Last updated
Apr 19, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

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

Authorized official

Name
Izzy Hirson
Title
Ceo
Phone
(949) 887-6379

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 300300BP CA Primary

Addresses

Primary practice location

10002 Briley Way
Villa Park, CA 92861-4219

Mailing address

8 Cheshire CT
Newport Beach, CA 92660-4210

Other names 1

  • Path to Serenity Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Path to Serenity3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1710411483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CHESHIRE CT",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926604210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10002 BRILEY WAY",
            "city": "VILLA PARK",
            "state": "CA",
            "postal_code": "928614219",
            "telephone_number": "949-887-6379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECOVERY BAY REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-19",
        "last_updated": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "HIRSON",
        "authorized_official_first_name": "IZZY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-887-6379"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "300300BP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Path to Serenity",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Villa Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; 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.