Principles Inc (Dba) Impact Drug & Alcohol Treatment Center

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

190094AN Issued in CA

Legal business name

PRINCIPLES INC (DBA) IMPACT DRUG & ALCOHOL TREATMENT CENTER

Practice address

1680 N Fair Oaks Ave
Pasadena, CA 91103-1642

Phone

(626) 798-0884

Fax

(626) 798-6970

NPI assigned

Feb 7, 2007

Organization subpart

No

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

Authorized official

Name

Mark Paquet, MBA, CAADE

Title

Admissions Director

Phone

(626) 798-0884

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Impact Doing business as

Tax ID family

Principles Inc Dba Impact Drug Alcohol Treatment Center3 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.

• Principles Inc (Dba) Impact Drug & Alcohol Treatment Center

  • Substance Abuse Rehabilitation Facility
  • Pasadena, CA
  • NPI 1497196075
  NPD tax ID
• Principles Inc.

  • Substance Abuse Rehabilitation Facility
  • Los Angeles, CA
  • NPI 1679917652
  NPD tax ID

Locations

Practitioners 1

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

• Michael Duane Stone, D.O.

  • Addiction Medicine (Family Medicine) Physician
  • Norwalk, CA
  • NPI 1629305479
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718323200000",
    "number": "1962542274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 N FAIR OAKS AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031642",
            "telephone_number": "626-798-0884",
            "fax_number": "626-798-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 N FAIR OAKS AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031642",
            "telephone_number": "626-798-0884",
            "fax_number": "626-798-6970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCIPLES INC (DBA) IMPACT DRUG & ALCOHOL TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A",
        "authorized_official_last_name": "PAQUET",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "ADMISSIONS DIRECTOR",
        "authorized_official_telephone_number": "626-798-0884",
        "authorized_official_credential": "MBA, CAADE"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190094AN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "1962542274",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "1962542274",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1962542274",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUM",
            "identifier": "1962542274",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "1962542274",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Impact",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Substance Abuse Rehabilitation Facility in Pasadena, CA
• Providers in Pasadena, 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 Jun 14, 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.