The House of the Rising Son

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

300633AP Issued in CA

Legal business name

THE HOUSE OF THE RISING SON

Doing business as

THORS Treatment Center

Practice address

521 W Avenida de Los Lobos Marinos
San Clemente, CA 92672-4374

Phone

(503) 793-8919

NPI assigned

Jun 1, 2016

Last updated

Jun 1, 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

Jacqueline F Bahu

Title

Owner/Cfo

Phone

(503) 793-8919

Specialties & licenses 1

Addresses

Other names 1

• THORS Treatment Center Doing business as

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464739200000",
    "number": "1912355850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 W AVENIDA DE LOS LOBOS MARINOS",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724374",
            "telephone_number": "503-793-8919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 W AVENIDA DE LOS LOBOS MARINOS",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724374",
            "telephone_number": "503-793-8919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HOUSE OF THE RISING SON",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-01",
        "last_updated": "2016-06-01",
        "status": "A",
        "authorized_official_last_name": "BAHU",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER/CFO",
        "authorized_official_telephone_number": "503-793-8919"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "300633AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THORS Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Substance Abuse Rehabilitation Facility in San Clemente, CA
• Providers in San Clemente, 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 Jun 1, 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.