RECOVERY BAY REHABILITATION CENTER (NPI# 1134653009) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134653009 |
| Entity Type | Organization |
| Organization Name | RECOVERY BAY REHABILITATION CENTER |
| Other Organization Name | PATH TO SERENITY |
| Practice Address |
1122 Bristol St Costa Mesa CA 92626-7972 |
| Mailing Address |
8 Cheshire Ct Newport Beach CA 92660-4210 |
| Practice Telephone | 9498876379 |
| Mailing Telephone | 9498876379 |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2017-04-17 |
| Authorized Official Name | IZZY HIRSON (CEO) |
| Authorized Official Telephone | 9498876379 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Path to Serenity | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710411483 | Recovery Bay Rehabilitation Center | Substance Abuse Rehabilitation Facility | 10002 Briley Way, Villa Park, CA 92861-4219 | 2017-04-19 |
| Street Address |
1122 BRISTOL ST |
| City | COSTA MESA |
| State | CA |
| Zip Code | 92626-7972 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536982 | Sergio Gutierrez | Behavior Technician | 3303 Harbor Blvd., Suite B8, Costa Mesa, CA 92626 | 2020-10-22 |
| 1780201848 | Kelly Chauvet | Behavior Technician | 1503 Nutmeg Place Suite 110, Costa Mesa, CA 92626 | 2020-07-06 |
| 1316564610 | Timo Rosa | Behavior Technician | 1503 Nutmeg Place, Suite 110, Costa Mesa, CA 92626 | 2020-07-02 |
| 1255966115 | Dalia A Sehweil | Behavior Technician | 1111 Baker, Costa Mesa, CA 92626 | 2020-03-11 |
| 1265071096 | Austin Stotelmyre | Behavior Technician | 1111 Baker St Costa Mesa 92626, Costa Mesa, CA 92626 | 2019-12-26 |
| 1396383022 | The Open Table | Community/Behavioral Health | 151 Kalmus Dr. Bldg C, Suite 100, Costa Mesa, CA 92626 | 2019-12-12 |
| 1851933550 | Jennifer Rivera | Behavior Technician | 1111 Baker St. Unit #a, Costa Mesa, CA 92626 | 2019-10-14 |
| 1962053595 | Peter Na | Behavior Technician | Behavior Functions 3303 Harbor Blvd, Ste B8, Costa Mesa, CA 92626 | 2019-09-25 |
| 1346897147 | Jennifer Lopez | Behavior Technician | 555 Alton Blvd Suite 150, Costa Mesa, CA 92626 | 2019-08-26 |
| 1679134084 | Danny Garcia Chiropractic, PC | Chiropractor | 1503 South Coast Drive, Suite 319, Costa Mesa, CA 92626 | 2019-06-26 |
| Find all providers in zip 92626 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497305635 | Elite Care, Inc. | Clinic/Center | 697 Plumer St, Costa Mesa, CA 92627-2720 | 2019-09-19 |
| 1427608660 | Elite Care, Inc. | Clinic/Center | 1991 Anaheim Avenue, B, Costa Mesa, CA 92627-9262 | 2019-09-19 |
| 1154800134 | Asana Recovery | Clinic/Center | 1730 Pomona Ave Ste 3, Costa Mesa, CA 92627-3628 | 2018-08-09 |
| 1427545276 | Clear Life Recovery | Clinic/Center | 2822 Monterey Ave, Costa Mesa, CA 92626-5535 | 2018-04-17 |
| 1760995260 | Monroe Operations, LLC | Clinic/Center | 3189 Pullman St, Costa Mesa, CA 92626-3320 | 2017-11-07 |
| 1790133346 | Sober Partners Waterfront Recovery | Clinic/Center | 1001 W 17th St Ste A, Costa Mesa, CA 92627-4512 | 2016-05-24 |
| 1477944908 | Elite Care, Inc. | Clinic/Center | 1991 Anaheim Ave Apt A, Costa Mesa, CA 92627-9305 | 2015-02-05 |
| 1669022703 | Elite Care, Inc. | Clinic/Center | 657 W 19th St, Costa Mesa, CA 92627-8600 | 2019-09-19 |
| 1689224826 | Elite Care, Inc. | Clinic/Center | 1991 Anaheim Avenue, C, Costa Mesa, CA 92627-9262 | 2019-09-19 |
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|---|---|---|---|---|
| 1609476845 | Vanity Wellness Center Incorporated | Clinic/Center | 19935 Ventura Blvd Fl 1, Woodland Hills, CA 91364-9605 | 2020-10-27 |
| 1184230328 | Recovery & Resilience Centers | Clinic/Center | 1665 Creekside Dr Ste 100, Folsom, CA 95630-3538 | 2020-09-22 |
| 1518573526 | A Ka Center, LLC | Clinic/Center | 4715 Divine Way, La Mesa, CA 91941-6832 | 2020-09-16 |
| 1821602186 | New Bridge Foundation, Inc. | Clinic/Center | 1777 Leroy Avenue, Berkeley, CA 94709-1156 | 2020-09-03 |
| 1942814793 | Ola Wellness Retreat, LLC | Clinic/Center | 26926 Pacific Coast Hwy, Malibu, CA 90265-4358 | 2020-08-31 |
| 1336752963 | Ola Wellness Retreat, LLC | Clinic/Center | 26924 Pacific Coast Hwy, Malibu, CA 90265-4356 | 2020-08-24 |
| 1003427337 | Restorative Partners, Inc. | Clinic/Center | 3220 S Higuera St Ste 103a, San Luis Obispo, CA 93401-2023 | 2020-08-11 |
| 1255941597 | Pathways Recovery | Clinic/Center | 4904 Hollycrest Way, Fair Oaks, CA 95628-5114 | 2020-08-02 |
| 1104435734 | New Life Health Authority / Dba New Life LLC | Clinic/Center | 280 E Standley St, Ukiah, CA 95482-4414 | 2020-07-29 |
| 1043829971 | House of Hope Foundation Inc | Clinic/Center | 227 W 9th St, San Pedro, CA 90731-3711 | 2020-07-27 |
| Find all providers with the same taxonomy | ||||
| City | COSTA MESA |
| Zip Code | 92626 |
Please comment or provide details below to improve the information on RECOVERY BAY REHABILITATION CENTER.
| 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.