NPIMap

Organization Active NPI

Sober Partners Waterfront Recovery

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Costa Mesa, CA
National Provider Identifier
1790133346
Registry record updated May 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
200205BP Issued in CA
Legal business name
SOBER PARTNERS WATERFRONT RECOVERY
Practice address
1001 W 17TH St Ste a
Costa Mesa, CA 92627-4512
Phone
(949) 201-5192
NPI assigned
May 24, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2019

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

Authorized official

Name
Scott Raffa
Title
Ceo
Phone
(949) 201-5192

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 200205BP CA Primary

Addresses

Primary practice location

1001 W 17TH St Ste a
Costa Mesa, CA 92627-4512

Mailing address

1001 W 17TH St Ste a
Costa Mesa, CA 92627-4512
Phone (949) 201-5192

National Provider Directory

National Provider Directory
Tax ID family
Partners Project Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1464048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556841600000",
    "number": "1790133346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W 17TH ST STE A",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926274512",
            "telephone_number": "949-201-5192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 W 17TH ST STE A",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926274512",
            "telephone_number": "949-201-5192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOBER PARTNERS WATERFRONT RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-24",
        "last_updated": "2019-05-03",
        "status": "A",
        "authorized_official_last_name": "RAFFA",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-201-5192"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CA",
            "license": "200205BP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; 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.