Central Recovery Center, LLC.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

CENTRAL RECOVERY CENTER, LLC.

Practice address

8050 N Palm Ave Ste 300
Fresno, CA 93711-5510

Phone

(559) 389-5098

NPI assigned

Nov 9, 2020

Last updated

Nov 9, 2020By 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

Randy Tyler Gomez

Title

Ceo

Phone

(559) 331-5214

Specialties & licenses 4

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604880000000",
    "number": "1871195446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8050 N PALM AVE STE 300",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115510",
            "telephone_number": "559-389-5098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8050 N PALM AVE STE 300",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115510",
            "telephone_number": "559-389-5098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL RECOVERY CENTER, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-08",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "TYLER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-331-5214"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.simplepractice.com/",
            "affiliation": "N",
            "endpointDescription": "Simple Practice: Scheduling, Messaging, TeleHealth etc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "8050 N Palm Ave Ste 300",
            "city": "Fresno",
            "state": "CA",
            "country_code": "US",
            "postal_code": "937115510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Marriage & Family Therapist in Fresno, CA
• Providers in Fresno, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.