City Recovery Intensive Outpatient Program

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

CITY RECOVERY INTENSIVE OUTPATIENT PROGRAM

Practice address

1100 W Town and Country Rd Ste 1208
Orange, CA 92868-4600

Phone

(714) 225-5994

NPI assigned

Dec 18, 2019

Last updated

Dec 20, 2019By 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

Jaman EleyNPI 1639888530

Title

Chief of Operations

Phone

(714) 225-5994

Specialties & licenses 1

Addresses

Locations

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.

• Jaman Robert Eley, SUDDC

  • Addiction (Substance Use Disorder) Counselor
  • Victorville, CA
  • NPI 1639888530
  NPD Authorized official
• Ross Alan Donahue, LCSW

  • Clinical Social Worker
  • Delray Beach, FL
  • NPI 1215627781
  NPD
• Ryan Soave, LMHC

  • Mental Health Counselor
  • Delray Beach, FL
  • NPI 1952091332
  NPD

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576800000000",
    "number": "1871131078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9592 PERIDOT AVE",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923448099",
            "telephone_number": "714-225-5994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W TOWN AND COUNTRY RD STE 1208",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684600",
            "telephone_number": "714-225-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY RECOVERY INTENSIVE OUTPATIENT PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-18",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A",
        "authorized_official_last_name": "ELEY",
        "authorized_official_first_name": "JAMAN",
        "authorized_official_title_or_position": "CHIEF OF OPERATIONS",
        "authorized_official_telephone_number": "714-225-5994"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victor Manuel Cisneros, M.D.
• Staphany Ayala Citan
• Imelda Donna Citrowski Jr.
• City of Orange
• City of Orange Physical Medicine Group Inc
• Stefan Octavian Ciurea, MD
• Hannah Clair
• Kiran Clair
• James Brian Clancy
• Taylor Clancy

• Substance Use Disorder Rehabilitation Clinic/Center in Orange, CA
• Providers in Orange, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.