Pura Vida Recovery Services, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

PURA VIDA RECOVERY SERVICES, LLC

Doing business as

Pura Vida Recovery Services

Practice address

6701 Montecito Blvd
Santa Rosa, CA 95409-2912

Phone

(707) 879-8432

Fax

(844) 426-0134

NPI assigned

Sep 24, 2024

Organization subpart

No

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

Authorized official

Name

Ben A Pahlavan

Title

Cao

Phone

(707) 879-8432

Specialties & licenses 1

Addresses

Other names 1

• Pura Vida Recovery Services Doing business as

Tax ID family

Pura Vida Recovery Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Pura Vida Recovery Services, LLC

  dba Pura Vida Recovery Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Santa Rosa, CA
  • NPI 1184445140
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roderick W Fontenette, MD

  • Emergency Medicine Physician
  • Travis Afb, CA
  • NPI 1164672499
  NPD (past)
• Katherine J Schwimmer

  • Clinical Psychologist
  • Sebastopol, CA
  • NPI 1578843801
  NPD (past)

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

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727136000000",
    "number": "1932926649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 CLEVELAND AVE STE 103",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032788",
            "telephone_number": "707-879-8432",
            "fax_number": "844-426-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 MONTECITO BLVD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954092912",
            "telephone_number": "707-879-8432",
            "fax_number": "844-426-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURA VIDA RECOVERY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A",
        "authorized_official_last_name": "PAHLAVAN",
        "authorized_official_first_name": "BEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "707-879-8432"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pura Vida Recovery Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pura Vida Recovery Services, LLC (Pura Vida Recovery Services)
• Pura Vida Recovery Services, LLC (Pura Vida Recovery Services)
• Pura Vida Recovery Services, LLC (Pura Vida Recovery Services)
• Pura Vida Recovery Services, LLC
• Pura Vida Recovery Services, LLC
• Parwinder Purewal
• Sukhpreet Kaur Purewal, PHARMD
• Alexis Renee Purugganan
• PW Jade LLC (Right at Home)
• Leslie Rae Pyles

• Substance Abuse Rehabilitation Facility in Santa Rosa, CA
• Providers in Santa Rosa, 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 Sep 24, 2024; 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.