NPIMap

Organization Active NPI

Adolescence's Last Resort

Doing business as The Last Resort

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Modesto, CA
National Provider Identifier
1841585015
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Hospital UnitTaxonomy code 276400000X
License
50010AN Issued in CA
Legal business name
ADOLESCENCE'S LAST RESORT
Doing business as
The Last Resort
Practice address
3125 McHenry Ave
Suite D
Modesto, CA 95350-1451
Phone
(209) 523-6900
NPI assigned
Jun 15, 2011
Last updated
Apr 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

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

Authorized official

Name
Michelle Denise Lucas
Title
Administrator
Phone
(209) 523-6900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Hospital Unit 276400000X 50010AN CA Primary

Addresses

Primary practice location

3125 McHenry Ave
Suite D
Modesto, CA 95350-1451

Mailing address

3125 McHenry Ave
Suite D
Modesto, CA 95350-1451
Phone (209) 523-6900

Other identifiers 3

IdentifierTypeStateIssuer
500010ANOtherCAALCOHOL AND DRUG PROGRAMS
5041OtherCADRUG MEDI-CAL
507004599OtherCADEPARTMENT OF SOCIAL SERVICES, CHILDRENS RESIDENTIAL PROGRAM

Other names 1

  • The Last Resort Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Adolescence's Last Resort2 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.

Locations

3125 McHenry Ave
Ste D
Modesto, CA 95350
Phone (209) 523-6900

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334016000000",
    "number": "1841585015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 MCHENRY AVE",
            "address_2": "SUITE D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953501451",
            "telephone_number": "209-523-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 MCHENRY AVE",
            "address_2": "SUITE D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953501451",
            "telephone_number": "209-523-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADOLESCENCE'S LAST RESORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-15",
        "last_updated": "2012-04-10",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "209-523-6900"
    },
    "taxonomies": [
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "CA",
            "license": "50010AN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALCOHOL AND DRUG PROGRAMS",
            "identifier": "500010AN",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRUG MEDI-CAL",
            "identifier": "5041",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF SOCIAL SERVICES, CHILDRENS RESIDENTIAL PROGRAM",
            "identifier": "507004599",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Last Resort",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; 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.