NPIMap

Organization Active NPI

Antelope Valley Rehabilitation Centers

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Lancaster, CA
National Provider Identifier
1730306499
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
ANTELOPE VALLEY REHABILITATION CENTERS
Practice address
44900 60TH St W
CHP Trailer
Lancaster, CA 93536-7618
Phone
(661) 945-8458
Fax
(661) 945-8248
NPI assigned
Apr 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Greg Haseltine
Title
Interim Executive Director
Phone
(661) 269-0074

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

44900 60TH St W
CHP Trailer
Lancaster, CA 93536-7618

Mailing address

PO Box 25
Acton, CA 93510-0025
Phone (661) 269-0062

Other identifiers 1

IdentifierTypeStateIssuer
6767OtherCAMEDI-CAL

National Provider Directory

National Provider Directory
Tax ID family
Hudson Health Center613 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 4

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": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730306499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25",
            "city": "ACTON",
            "state": "CA",
            "postal_code": "935100025",
            "telephone_number": "661-269-0062",
            "fax_number": "661-269-0427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44900 60TH ST W",
            "address_2": "CHP TRAILER",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935367618",
            "telephone_number": "661-945-8458",
            "fax_number": "661-945-8248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTELOPE VALLEY REHABILITATION CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HASELTINE",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "INTERIM EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "661-269-0074"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "6767",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.