SACRED SPACE HEALING & RETREAT CENTER INTERNATIONAL, INC. (NPI# 1043768807) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043768807 |
| Entity Type | Organization |
| Organization Name | SACRED SPACE HEALING & RETREAT CENTER INTERNATIONAL, INC. |
| Other Organization Name | SACRED SPACE RETREATS |
| Practice Address |
627 Cherry Creek Rd. Box 311 Cloverdale CA 95425 |
| Practice Telephone | 7078940063 |
| Mailing Telephone | 7078940063 |
| Mailing Fax Number | 8009146360 |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2016-09-21 |
| Authorized Official Name | MR. ANUSHA AMEN-RA (CEO / PRESIDENT) |
| Authorized Official Telephone | 7078940063 |
| Authorized Official Credential | C.N.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 490039AP | CA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Sacred Space Retreats | Doing Business As Name - Organization |
| Street Address |
627 CHERRY CREEK RD. BOX 311 |
| City | CLOVERDALE |
| State | CA |
| Zip Code | 95425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992353148 | Beverly D. Westenberg | Technician | 20 King Ridge Hts., Cloverdale, CA 95425 | 2019-08-30 |
| 1952637027 | County of Sonoma | Clinic/Center | 140 S Cloverdale Blvd, Cloverdale, CA 95425 | 2009-10-26 |
| 1144318213 | Mark William Garwah | Chiropractor | 142 S Cloverdale Blvd, Cloverdale, CA 95425 | 2006-10-11 |
| 1487605747 | Kevin Joseph Garvin | Dentist | 118 East 2nd Street, Cloverdale, CA 95425 | 2006-05-12 |
| 1508833153 | Cheri Lynn Heffel | Nurse Practitioner | 240 N Cloverdale Blvd, Copper Towers Family Medical Center, Cloverdale, CA 95425 | 2006-03-02 |
| 1356452262 | Ronald D Schuster | Chiropractor | 240 N Cloverdale Blvd, Suite E, Cloverdale, CA 95425 | 2006-08-31 |
| 1184731234 | Richard A Nicholls | Dentist | 114 N Main St, Cloverdale, CA 95425 | 2006-08-24 |
| 1437636701 | Audrey Duong | Dentist | 100 W 3rd St, Cloverdale, CA 95425-3204 | 2018-07-19 |
| 1699106781 | Coppertower Family Medical Center | Clinic/Center | 100 W 3rd St, Cloverdale, CA 95425-3204 | 2013-11-27 |
| 1386076156 | Department of Health Services | Clinic/Center | 100 W 3rd St, Cloverdale, CA 95425-3204 | 2013-08-05 |
| Find all providers in zip 95425 | ||||
| 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 |
|---|---|---|---|---|
| 1801497359 | California Care Detox & Treatment | Substance Abuse Rehabilitation Facility | 25542 Dana Mesa Dr, San Juan Capistrano, CA 92675-4311 | 2020-11-02 |
| 1952900797 | A Sacred Path | Substance Abuse Rehabilitation Facility | 5671 Spanish Flat Rd, Garden Valley, CA 95633 | 2020-10-22 |
| 1467051672 | Spearhead Health Centers, LLC. | Substance Abuse Rehabilitation Facility | 11704 Wilshire Blvd Ste 226, Los Angeles, CA 90025-1504 | 2020-10-19 |
| 1073111613 | A Place To Heal | Substance Abuse Rehabilitation Facility | 14540 Hamlin St Ste H, Van Nuys, CA 91411-4153 | 2020-10-15 |
| 1871191569 | Old Oak Ranch Recovery Center | Substance Abuse Rehabilitation Facility | 19401 Susan Way, Sonora, CA 95370-9266 | 2020-10-14 |
| 1962009845 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 9952 Grandview Dr, La Mesa, CA 91941-6874 | 2020-10-05 |
| 1376140384 | Magic House Recovery Inc | Substance Abuse Rehabilitation Facility | 1001 S Mountvale Ct, Anaheim, CA 92808-2108 | 2020-10-02 |
| 1942807060 | New Perceptions North, LLC | Substance Abuse Rehabilitation Facility | 5084 N Fruit Ave Ste 105, Fresno, CA 93711-3000 | 2020-10-01 |
| 1346857679 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 3480 Hidden Trail Dr, Jamul, CA 91935-2104 | 2020-09-30 |
| 1992312227 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 2810 Camino Del Rio S Ste 106, San Diego, CA 92108-3819 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
| City | CLOVERDALE |
| Zip Code | 95425 |
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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.