Pacific Sands Recovery Center LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

PACIFIC SANDS RECOVERY CENTER LLC

Practice address

1909 W Carlton PL
Santa Ana, CA 92704-4206

Phone

(844) 568-7328

NPI assigned

Mar 8, 2021

Organization subpart

No

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

Authorized official

Name

Daniel Hollenbeck

Title

Ceo

Phone

(844) 568-7328

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702252800000",
    "number": "1750976064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 580",
            "city": "SPRING HILL",
            "state": "TN",
            "postal_code": "371740580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 W CARLTON PL",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927044206",
            "telephone_number": "844-568-7328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC SANDS RECOVERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-08",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A",
        "authorized_official_last_name": "HOLLENBECK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "844-568-7328"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Santa Ana, CA
• Providers in Santa Ana, 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 Dec 11, 2023; 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.