NPIMap

Organization Active NPI

Reviving You Recovery House LLC

  • Substance Abuse Rehabilitation Facility
  • Menifee, CA
National Provider Identifier
1770158545
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
REVIVING YOU RECOVERY HOUSE LLC
Practice address
28889 Park Trail Way
Menifee, CA 92584-7395
Phone
(760) 420-6654
NPI assigned
May 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Authorized official

Name
Dustin Hensley
Title
Owner
Phone
(760) 420-6654

Specialties & licenses 1

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

Addresses

Primary practice location

28889 Park Trail Way
Menifee, CA 92584-7395

Mailing address

28889 Park Trail Way
Menifee, CA 92584-7395
Phone (760) 420-6654

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL revivingyourecoveryhouse@gmail.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Reviving You Recovery House LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1621900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1770158545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28889 PARK TRAIL WAY",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925847395",
            "telephone_number": "760-420-6654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28889 PARK TRAIL WAY",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925847395",
            "telephone_number": "760-420-6654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVING YOU RECOVERY HOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "HENSLEY",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-420-6654"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "revivingyourecoveryhouse@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Communication exchange",
            "address_1": "28889 Park Trail Way",
            "city": "Menifee",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925847395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Menifee, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.