Red Phoenix Recovery LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

RED PHOENIX RECOVERY LLC

Doing business as

Red Phoenix Recovery

Practice address

1554 Wood St
Fortuna, CA 95540-3541

Phone

(707) 498-1865

NPI assigned

Mar 25, 2024

Last updated

Mar 25, 2024By 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. Marilynne Sue Walpole, CADC LL-CANPI 1043965700

Title

Owner/Ceo

Phone

(707) 498-1865

Specialties & licenses 1

Addresses

Other names 1

• Red Phoenix Recovery Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marilynne Sue Walpole, CADC L CA

  • Addiction (Substance Use Disorder) Counselor
  • Eureka, CA
  • NPI 1043965700
  Authorized official Same address or phone

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711324800000",
    "number": "1962252908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1554 WOOD ST",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "955403541",
            "telephone_number": "707-498-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1554 WOOD ST",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "955403541",
            "telephone_number": "707-498-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED PHOENIX RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-23",
        "status": "A",
        "authorized_official_last_name": "WALPOLE",
        "authorized_official_first_name": "MARILYNNE",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "707-498-1865",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CADC LL-CA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Phoenix Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Galen Wayne Pettey, PHYSICAL THERAPIST
• Philip L. Olkin, M.D. and C. Ray Jones, M.D.
• Felice Philips
• Lacey Pipher
• Anthony Pirouz, PA-C
• Redwood Internal Medicine (Huppenbauer & Rangel MD)
• Redwood Memorial Hospital
• Redwood Pediatric Medical Group
• Redwood Radiology Imaging Medical Clinic
• Redwood Women's Center, a Medical Corporation

• Community/Behavioral Health Agency in Fortuna, CA
• Providers in Fortuna, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.