NPIMap

Organization Active NPI

Tikva Treatment

Doing business as The Haven at Pismo

  • Substance Abuse Rehabilitation Facility
  • Arroyo Grande, CA
National Provider Identifier
1770038663
Registry record updated Aug 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
400009CP Issued in CA
Legal business name
TIKVA TREATMENT
Doing business as
The Haven at Pismo
Practice address
2030 Idyllwild PL
Arroyo Grande, CA 93420-9601
Phone
(805) 202-3440
Fax
(888) 510-9071
NPI assigned
Aug 20, 2016
Last updated
Aug 20, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2016

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

Authorized official

Name
Mr. Ari Hirt, MBA
Title
Ceo
Phone
(310) 502-6991

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 400009CP CA Primary

Addresses

Primary practice location

2030 Idyllwild PL
Arroyo Grande, CA 93420-9601

Mailing address

2030 Idyllwild PL
Arroyo Grande, CA 93420-9601
Phone (805) 202-3440

Other identifiers 1

IdentifierTypeStateIssuer
400009CPOtherCASTATE OF CALIFORNIA DEPT OF HEALTH

Other names 1

  • THE HAVEN AT PISMO Doing business as

National Provider Directory

National Provider Directory
Tax ID family
The Haven at Pismo5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1471651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471651200000",
    "number": "1770038663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 IDYLLWILD PL",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934209601",
            "telephone_number": "805-202-3440",
            "fax_number": "888-510-9071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 IDYLLWILD PL",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934209601",
            "telephone_number": "805-202-3440",
            "fax_number": "888-510-9071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIKVA TREATMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-20",
        "last_updated": "2016-08-20",
        "status": "A",
        "authorized_official_last_name": "HIRT",
        "authorized_official_first_name": "ARI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-502-6991",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "400009CP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA DEPT OF HEALTH",
            "identifier": "400009CP",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE HAVEN AT PISMO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arroyo Grande, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.