NPIMap

Organization Active NPI

Lake Arrowhead Recovery Center

  • Substance Abuse Rehabilitation Facility
  • Lake Arrowhead, CA
National Provider Identifier
1730638925
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
LAKE ARROWHEAD RECOVERY CENTER
Practice address
28729 Palisades Drive
Lake Arrowhead, CA 92352
Phone
(435) 590-4147
NPI assigned
Sep 28, 2016
Last updated
Sep 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Authorized official

Name
Dr. Michael Shawn Valdez, M.D.
Title
Physician/Medical Director
Phone
(909) 553-0626

Specialties & licenses 1

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

Addresses

Primary practice location

28729 Palisades Drive
Lake Arrowhead, CA 92352

Mailing address

P.O. Box 2013
Lake Arrowhead, CA 92352
Phone (435) 590-4147

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1475020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475020800000",
    "number": "1730638925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2013",
            "city": "LAKE ARROWHEAD",
            "state": "CA",
            "postal_code": "92352",
            "telephone_number": "435-590-4147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28729 PALISADES DRIVE",
            "city": "LAKE ARROWHEAD",
            "state": "CA",
            "postal_code": "92352",
            "telephone_number": "435-590-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE ARROWHEAD RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-28",
        "last_updated": "2016-09-28",
        "status": "A",
        "authorized_official_last_name": "VALDEZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "SHAWN",
        "authorized_official_title_or_position": "PHYSICIAN/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "909-553-0626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Arrowhead, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; 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.