NPIMap

Organization Active NPI

Balboa Recovery

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Newport Beach, CA
National Provider Identifier
1730436809
Registry record updated Aug 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
BALBOA RECOVERY
Practice address
3206 W Balboa Blvd
Newport Beach, CA 92663-3018
Phone
(949) 400-7120
NPI assigned
Aug 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2012

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

Authorized official

Name
Kevin CullenNPI 1407103567
Title
President Ceo
Phone
(949) 400-7120

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

3206 W Balboa Blvd
Newport Beach, CA 92663-3018

Mailing address

3419 Via Lido
Newport Beach, CA 92663-3908
Phone (949) 400-7120

National Provider Directory

National Provider Directory
Tax ID family
Balboa Recovery4 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.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344384000000",
    "number": "1730436809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419 VIA LIDO",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633908",
            "telephone_number": "949-400-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3206 W BALBOA BLVD",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633018",
            "telephone_number": "949-400-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALBOA RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-08",
        "last_updated": "2012-08-08",
        "status": "A",
        "authorized_official_last_name": "CULLEN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "949-400-7120"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; 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.