Avista Recovery

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

AVISTA RECOVERY

Practice address

12359 Wolf Run Rd
Noblesville, IN 46060-7232

Phone

(630) 815-7737

NPI assigned

Dec 27, 2016

Last updated

Dec 27, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Charles Licari

Title

Ceo

Phone

(630) 815-7737

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1482796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482796800000",
    "number": "1871038067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12359 WOLF RUN RD",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460607232",
            "telephone_number": "630-815-7737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12359 WOLF RUN RD",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460607232",
            "telephone_number": "630-815-7737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVISTA RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-27",
        "last_updated": "2016-12-27",
        "status": "A",
        "authorized_official_last_name": "LICARI",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "630-815-7737",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Noblesville, IN
• Providers in Noblesville, IN by specialty
• Substance Abuse Rehabilitation Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.