MY TIME RECOVERY, LLC (NPI# 1023626694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023626694 |
| Entity Type | Organization |
| Organization Name | MY TIME RECOVERY, LLC |
| Practice Address |
1015 E Indianapolis Ave Fresno CA 93704-3819 |
| Mailing Address |
83 E Shaw Ave Fresno CA 93710-7620 |
| Practice Telephone | 7024192592 |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2020-07-20 |
| Authorized Official Name | NICOLE NYGREN (OPERATIONS MANAGER) |
| Authorized Official Telephone | 7024192592 |
| Is Organization Subpart | Y |
| Parent Organization Name | MY TIME RECOVERY, LLC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114431897 | My Time Recovery, LLC | Community/Behavioral Health | 1107 W Rialto Ave, Fresno, CA 93705-0918 | 2017-11-17 |
| 1740786557 | My Time Recovery, LLC | Substance Abuse Rehabilitation Facility | 1107 W Rialto Ave, Fresno, CA 93705-0918 | 2018-04-02 |
| Street Address |
1015 E INDIANAPOLIS AVE |
| City | FRESNO |
| State | CA |
| Zip Code | 93704-3819 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093090466 | Jennifer H Yun | Pharmacist | 5747 North Palm, Fresno, CA 93704 | 2011-10-18 |
| 1437395704 | Kenneth L. Hallstone | Marriage & Family Therapist | 4040 N. Wilson St., Fresno, CA 93704 | 2008-12-17 |
| 1811147796 | Kenneth S. Masumoto Dds Inc | Dentist | 430 W. Shaw, Fresno, CA 93704 | 2008-09-26 |
| 1578760526 | Wanda Kay Gordon Mcintosh | Social Worker | 5588 N Palm Ave # 10, Fresno, CA 93704 | 2007-07-02 |
| 1285839456 | Alison Elise Armstrong-conner | Psychologist | 6475 N. Palm Avenue, Suite 101, Fresno, CA 93704 | 2007-06-18 |
| 1952519498 | Henry Truong | Student in an Organized Health Care Education/Training Program | 615 E. Clinton Ave., Fresno, CA 93704 | 2007-05-18 |
| 1205042900 | Michelle Kathleen Gash | Clinic/Center | 5464 N Palm Ave # 101, Fresno, CA 93704 | 2007-05-16 |
| 1467674705 | Loyds Liberty Homes, Inc | Intermediate Care Facility, Mentally Retarded | 6520 North Colonial, Fresno, CA 93704 | 2007-05-03 |
| 1952522559 | Dawn Keisha Denise Aholu | Occupational Therapist | 5180 N. Palm, Suite 102, Fresno, CA 93704 | 2007-05-01 |
| 1235359191 | Yolanda Rodriguez Andreatta | Dental Hygienist | 310 W Shaw, Fresno, CA 93704 | 2007-04-25 |
| Find all providers in zip 93704 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807060 | New Perceptions North, LLC | Substance Abuse Rehabilitation Facility | 5084 N Fruit Ave Ste 105, Fresno, CA 93711-3000 | 2020-10-01 |
| 1659826287 | Comprehensive Addiction Program | Substance Abuse Rehabilitation Facility | 2492 S Backer Ave, Fresno, CA 93725-1605 | 2016-08-24 |
| 1275088817 | Comprehensive Addiction Program | Substance Abuse Rehabilitation Facility | 4647 N Chestnut Ave Apt 101, Fresno, CA 93726-1803 | 2016-08-24 |
| 1588067912 | Sierra Tribal Consortium, Inc. | Substance Abuse Rehabilitation Facility | 610 W Mckinley Ave, Fresno, CA 93728-1425 | 2014-09-30 |
| 1104245489 | Dunamis, Inc. Group Home | Substance Abuse Rehabilitation Facility | 1509 N Maroa Ave, Fresno, CA 93728-1815 | 2014-04-15 |
| 1710247762 | King of Kings Men's Recovery Home | Substance Abuse Rehabilitation Facility | 2267 S Geneva Ave, Fresno, CA 93706-4326 | 2012-05-24 |
| 1720221443 | Comprehensive Addiction Programs Inc | Substance Abuse Rehabilitation Facility | 2445 W Whitesbridge Road, Fresno, CA 93706-1225 | 2009-04-10 |
| 1497939441 | Westcare California, Inc. | Substance Abuse Rehabilitation Facility | 2855 W. Whitesbridge Road, Fresno, CA 93706 | 2007-12-27 |
| 1407064843 | Universal Health Network and Systems, Inc. | Substance Abuse Rehabilitation Facility | 3170 N Chestnut Ave, Suite 105, Fresno, CA 93703 | 2007-05-18 |
| 1861610735 | Eleventh Hour Rehabilitation Programs | Substance Abuse Rehabilitation Facility | 5639 E Park Circle Dr, Fresno, CA 93727-5413 | 2007-04-23 |
| Find all providers in FRESNO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.