Mazzy Development Center

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MAZZY DEVELOPMENT CENTER

Doing business as

Mission Recovery Home

Practice address

23792 Rockfield Blvd Ste 230
Lake Forest, CA 92630-2872

Phone

(949) 322-1202

NPI assigned

Apr 15, 2024

Last updated

Mar 1, 2025By 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

Mrs. Metra Azar-Salem, PSYD

Title

Officer

Phone

(949) 322-1202

Specialties & licenses 5

Addresses

Other names 1

• Mission Recovery Home Doing business as

Locations

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740787200000",
    "number": "1912751231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23791 ROCKFILED",
            "address_2": "#230",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "92630",
            "telephone_number": "949-322-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23792 ROCKFIELD BLVD STE 230",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302872",
            "telephone_number": "949-322-1202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "67 Sanctuary",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926203425",
            "country_code": "US",
            "telephone_number": "888-877-7710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAZZY DEVELOPMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-15",
        "last_updated": "2025-03-01",
        "certification_date": "2025-03-01",
        "status": "A",
        "authorized_official_last_name": "AZAR-SALEM",
        "authorized_official_first_name": "METRA",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "949-322-1202",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mission Recovery Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mission Recovery Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Carolyn Anna McClung

• Clinic/Center in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2025; 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.