Bay Area Teens, LLC

Primary specialty

Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X

License

435202483 Issued in CA

Legal business name

BAY AREA TEENS, LLC

Practice address

1203 Las Palmas Dr
Santa Clara, CA 95051-3923

Phone

(408) 705-5200

NPI assigned

Nov 12, 2014

Last updated

Nov 12, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Gillian August-Thorp, M.A.

Title

Owner, Managing Member

Phone

(408) 705-5200

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1415750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415750400000",
    "number": "1760888168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2634 MAPLEWOOD LN",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950516235",
            "telephone_number": "408-705-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 LAS PALMAS DR",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950513923",
            "telephone_number": "408-705-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY AREA TEENS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-12",
        "last_updated": "2014-11-12",
        "status": "A",
        "authorized_official_last_name": "AUGUST-THORP",
        "authorized_official_first_name": "GILLIAN",
        "authorized_official_title_or_position": "OWNER, MANAGING MEMBER",
        "authorized_official_telephone_number": "408-705-5200",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "CA",
            "license": "435202483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Children's Substance Abuse Rehabilitation Facility in Santa Clara, CA
• Providers in Santa Clara, CA by specialty
• Children's Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; 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.