S&S Supportive Housing LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

S&S SUPPORTIVE HOUSING LLC

Doing business as

San Diego Coastal Recovery

Practice address

1719 National Ave
San Diego, CA 92113-1010

Phone

(619) 234-6192

NPI assigned

Feb 17, 2025

Last updated

Feb 17, 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

Terris Bolden

Title

MBR

Phone

(619) 234-6192

Specialties & licenses 1

Addresses

Other names 1

• San Diego Coastal Recovery Doing business as

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

{
    "created_epoch": "1739750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739750400000",
    "number": "1952106551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 NATIONAL AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921131010",
            "telephone_number": "619-234-6192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 NATIONAL AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921131010",
            "telephone_number": "619-234-6192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S&S SUPPORTIVE HOUSING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-17",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A",
        "authorized_official_last_name": "BOLDEN",
        "authorized_official_first_name": "TERRIS",
        "authorized_official_title_or_position": "MBR",
        "authorized_official_telephone_number": "619-234-6192"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Diego Coastal Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Substance Abuse Rehabilitation Facility in San Diego, CA
• Providers in San Diego, 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 Feb 17, 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.