MLRC, Inc.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

MLRC, INC.

Doing business as

MyLife Recovery Centers IOP

Practice address

6073 N 1St St Ste 102
Fresno, CA 93710-5444

Phone

(559) 202-3830

NPI assigned

Dec 12, 2016

Organization subpart

No

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

Authorized official

Name

Scott Andrew Funkhouser, CATC

Title

Interim Director

Phone

(812) 204-4324

Specialties & licenses 1

Addresses

Other names 1

• MyLife Recovery Centers IOP Doing business as

Tax ID family

MLRC Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• MLRC, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Rancho Mirage, CA
  • NPI 1538603345
  NPD tax ID
• MLRC, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Walnut Creek, CA
  • NPI 1790229771
  NPD tax ID

Locations

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

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481500800000",
    "number": "1932643814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6073 N 1ST ST STE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105444",
            "telephone_number": "559-202-3830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6073 N 1ST ST STE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105444",
            "telephone_number": "559-202-3830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MLRC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-12",
        "last_updated": "2016-12-12",
        "status": "A",
        "authorized_official_last_name": "FUNKHOUSER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "INTERIM DIRECTOR",
        "authorized_official_telephone_number": "812-204-4324",
        "authorized_official_credential": "CATC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyLife Recovery Centers IOP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gregory Miyake, DDS
• MJ Palau DDS Inc.
• MKG Enterprises Corp.
• Arpine Mkhitaryan
• Gevork Mkrtchyan
• Anoosh Moadab, D.P.M.
• Pezhman Mobasher, MD
• Andrew Mobius, PA-C
• Nyssa Nicole Mobley, MASSAGE THERAPIST
• Robert Michele Mochizuki, M.D.

• Substance Use Disorder Rehabilitation Clinic/Center in Fresno, CA
• Providers in Fresno, 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 12, 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.