NPIMap

Organization Active NPI

Tikva Treatment

  • Substance Abuse Rehabilitation Facility
  • Arroyo Grande, CA
National Provider Identifier
1871048769
Registry record updated Aug 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
400009AP Issued in CA
Legal business name
TIKVA TREATMENT
Practice address
107 Nelson St
Arroyo Grande, CA 93420-3318
Phone
(805) 202-3440
Fax
(888) 510-9071
NPI assigned
Aug 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2016

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

Authorized official

Name
Ari Hirt, MBA
Title
Ceo
Phone
(310) 502-6991

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 400009AP CA Primary

Addresses

Primary practice location

107 Nelson St
Arroyo Grande, CA 93420-3318

Mailing address

929 Hidden Pine LN
Arroyo Grande, CA 93420-7143
Phone (805) 202-3440

Other identifiers 1

IdentifierTypeStateIssuer
400009APOtherCASTATE 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.

NPI Registry JSON

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

{
    "created_epoch": "1471651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471651200000",
    "number": "1871048769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 HIDDEN PINE LN",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934207143",
            "telephone_number": "805-202-3440",
            "fax_number": "888-510-9071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 NELSON ST",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934203318",
            "telephone_number": "805-202-3440",
            "fax_number": "888-510-9071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIKVA TREATMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-20",
        "last_updated": "2016-08-20",
        "status": "A",
        "authorized_official_last_name": "HIRT",
        "authorized_official_first_name": "ARI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-502-6991",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "400009AP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA DEPT OF HEALTH",
            "identifier": "400009AP",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "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 Aug 20, 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.