NPIMap

Organization Active NPI

Tikva Treatment LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Arroyo Grande, CA
National Provider Identifier
1831541986
Registry record updated Mar 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
400009BP Issued in CA
Legal business name
TIKVA TREATMENT LLC
Practice address
621 E Grande Ave
Arroyo Grande, CA 93420
Phone
(805) 202-3440
Fax
(805) 202-3441
NPI assigned
Jul 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2019

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

Authorized official

Name
Mr. Ari Hirt, MBA
Title
Owner/Ceo
Phone
(805) 202-3440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 400009BP CA Primary

Addresses

Primary practice location

621 E Grande Ave
Arroyo Grande, CA 93420

Mailing address

391 Front Street
Suite F
Grover Beach, CA 93433
Phone (805) 202-3440

Other identifiers 1

IdentifierTypeStateIssuer
400009BPOtherCASTATE 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.

Locations

621 E Grand Ave
Arroyo Grande, CA 93420
Phone (805) 202-3440

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551398400000",
    "number": "1831541986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 FRONT STREET",
            "address_2": "SUITE F",
            "city": "GROVER BEACH",
            "state": "CA",
            "postal_code": "93433",
            "telephone_number": "805-202-3440",
            "fax_number": "805-202-3441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 E GRANDE AVE",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "93420",
            "telephone_number": "805-202-3440",
            "fax_number": "805-202-3441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIKVA TREATMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-12",
        "last_updated": "2019-03-01",
        "status": "A",
        "authorized_official_last_name": "HIRT",
        "authorized_official_first_name": "ARI",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "805-202-3440",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CA",
            "license": "400009BP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA DEPT OF HEALTH",
            "identifier": "400009BP",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE HAVEN AT PISMO",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "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 Mar 1, 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.