Healing Tree Rehab, Inc,

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

HEALING TREE REHAB, INC,

Practice address

6969 Vista del Rincon Dr
Ventura, CA 93001-9782

Phone

(626) 308-0274

Fax

(805) 830-1755

NPI assigned

Sep 28, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Brian W. Kellogg, J.D.

Title

C.E.O.

Phone

(626) 318-0274

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632787200000",
    "number": "1972275097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6969 VISTA DEL RINCON DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930019782",
            "telephone_number": "626-308-0274",
            "fax_number": "805-830-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6969 VISTA DEL RINCON DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930019782",
            "telephone_number": "626-308-0274",
            "fax_number": "805-830-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING TREE REHAB, INC,",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "KELLOGG",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "626-318-0274",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "J.D."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Ventura, CA
• Providers in Ventura, 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 28, 2021; 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.