NPIMap

Organization Active NPI

Principles Inc (Dba) Impact Drug & Alcohol Treatment Center

Doing business as Impact

  • Substance Abuse Rehabilitation Facility
  • Pasadena, CA
National Provider Identifier
1962542274
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
190094AN Issued in CA
Legal business name
PRINCIPLES INC (DBA) IMPACT DRUG & ALCOHOL TREATMENT CENTER
Doing business as
Impact
Practice address
1680 N Fair Oaks Ave
Pasadena, CA 91103-1642
Phone
(626) 798-0884
Fax
(626) 798-6970
NPI assigned
Feb 7, 2007
Last updated
Jun 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Authorized official

Name
Mark Paquet, MBA, CAADENPI 1285021741
Title
Admissions Director
Phone
(626) 798-0884

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 190094AN CA Primary

Addresses

Primary practice location

1680 N Fair Oaks Ave
Pasadena, CA 91103-1642

Mailing address

1680 N Fair Oaks Ave
Pasadena, CA 91103-1642
Phone (626) 798-0884

Other names 1

  • Impact Doing business as

National Provider Directory

National Provider Directory
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.

Locations

1450 N Lake Ave
Ste 2
Pasadena, CA 91104

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Impact",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pasadena, CA

Sources for this page

  • 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.