THOMAS HATHORN (NPI# 1093118176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093118176 |
| Entity Type | Individual |
| Full Name | THOMAS HATHORN |
| Practice Address |
24352 Featherstone Canyon Rd. Lakeside CA 92040 |
| Mailing Address |
Po Box 1279 Lakeside CA 92040-0908 |
| Practice Telephone | 6197977319 |
| Mailing Telephone | 8587174322 |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2014-10-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 370139AN | CA | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023241338 | Thomas Wayne Hathorn | Dentist | 402 Pinegrove Dr, Pineville, LA 71360-5726 | 2009-09-02 |
| Street Address |
24352 FEATHERSTONE CANYON RD. |
| City | LAKESIDE |
| State | CA |
| Zip Code | 92040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831585561 | Genesis Recovery, Inc. | Substance Abuse Rehabilitation Facility | 24352 Featherstone Canyon Rd., Lakeside, CA 92040 | 2015-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912507476 | Edna Jean Collins | Registered Nurse | 15611 Mountain Valley Place, Lakeside, CA 92040 | 2020-10-26 |
| 1881180073 | Ryle Stous | Physical Therapist | 13552 Julian Ave, Lakeside, CA 92040 | 2018-07-10 |
| 1649709932 | Good Care Transportation, LLC | Non-emergency Medical Transport (VAN) | 10553 Valle Vista Rd, Lakeside, CA 92040 | 2017-06-08 |
| 1124555461 | Jacob Milton Murdock Iv | Student in an Organized Health Care Education/Training Program | 12064 Woodside Ave Suite 105, San Diego Center for Neurofeedback, Lakeside, CA 92040 | 2017-05-17 |
| 1891152369 | Kathy Gamboa II | Registered Nurse | 9636 Caminito Macklin, Lakeside, CA 92040 | 2016-01-28 |
| 1730361569 | The Arc of San Diego | Intermediate Care Facility, Mentally Retarded | 9075 Creekford Drive, Lakeside, CA 92040 | 2007-12-04 |
| 1134771512 | Thais Dinese St Martin | Speech-Language Pathologist | 12335 Woodside Ave, Lakeside, CA 92040 | 2019-07-15 |
| 1699047506 | Amy S. Woh | Counselor | 12064 Woodside Ave Ste 105, Lakeside, CA 92040 | 2012-02-08 |
| 1811272065 | Lea Capuno Evangelista | Pharmacist | 9728 Winter Gardens Blvd, Lakeside, CA 92040 | 2011-10-19 |
| 1760464960 | Charles Francis Plante | Chiropractor | 11965 Ericas Way, Lakeside, CA 92040-1029 | 2005-11-15 |
| Find all providers in zip 92040 | ||||
| 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 |
|---|---|---|---|---|
| 1831585561 | Genesis Recovery, Inc. | Substance Abuse Rehabilitation Facility | 24352 Featherstone Canyon Rd., Lakeside, CA 92040 | 2015-04-09 |
| 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 | ||||
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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.