Domus Retreat, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

300203AP Issued in CA

Legal business name

DOMUS RETREAT, LLC

Practice address

270 S Orange Acres Dr
Anaheim, CA 92807-3617

Phone

(310) 246-1323

NPI assigned

May 16, 2011

Organization subpart

No

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

Authorized official

Name

Clare Waismann

Title

Manager

Phone

(310) 205-0808

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305504000000",
    "number": "1851684468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N ROBERTSON BLVD",
            "address_2": "SUITE 419",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111788",
            "telephone_number": "310-246-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 S ORANGE ACRES DR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928073617",
            "telephone_number": "310-246-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMUS RETREAT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-16",
        "last_updated": "2011-05-16",
        "status": "A",
        "authorized_official_last_name": "WAISMANN",
        "authorized_official_first_name": "CLARE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "310-205-0808"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "300203AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Dawn Dominguez
• Mario Dominguez
• Ruben Dominguez
• Vanessa Dominguez
• Viviana Dominguez
• Don Garcia MD Inc
• Don Son, MD, Inc.
• Jessica Donaldson
• Jeffrey R. Donath, MD
• Francisca Del Carmen Donato- Sandoval

• Substance Abuse Rehabilitation Facility in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2011; 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.