IRECOVERY BEHAVIORAL HEALTH CLINIC, LLC (NPI# 1164873253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164873253 |
| Entity Type | Organization |
| Organization Name | IRECOVERY BEHAVIORAL HEALTH CLINIC, LLC |
| Other Organization Name | IRECOVERY SANTA MARIA |
| Practice Address |
607 Plaza Dr Suite C-102 Santa Maria CA 93454-6944 |
| Mailing Address |
68778 E Palm Canyon Dr Cathedral City CA 92234-1313 |
| Practice Telephone | 8056315268 |
| Practice Fax Number | 8056315264 |
| Mailing Telephone | 8056315268 |
| Mailing Fax Number | 8056315264 |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2016-06-29 |
| Authorized Official Name | JOHN KROLL (SUPERVISOR) |
| Authorized Official Telephone | 8056315268 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| iRecovery Santa Maria | Doing Business As Name - Organization |
| Street Address |
607 PLAZA DR SUITE C-102 |
| City | SANTA MARIA |
| State | CA |
| Zip Code | 93454-6944 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902022890 | Coast Family Practice | Physician Assistant | 607 Plaza Dr, Suite C201, Santa Maria, CA 93454-6944 | 2007-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164995825 | Virgilia Elizabeth Kennedy | Counselor | 1505 Shepard Drive, Suite 204, Santa Maria, CA 93454 | 2019-01-05 |
| 1891290151 | Philbert Ramirez Pandac | Behavioral Analyst | 1016 East Maint Street, Santa Maria, CA 93454 | 2018-03-28 |
| 1487166120 | Good Samaritan Shelter | Family Medicine | 412 East Tunnell Street, Santa Maria, CA 93454 | 2017-11-03 |
| 1306357892 | Aklilu Joseph | Pharmacist | 1700 S. Bradley Rd, Santa Maria, CA 93454 | 2017-10-24 |
| 1225557267 | Eric Edward Lofstrand | Counselor | 1214 S Miller St Ste 11, Santa Maria, CA 93454 | 2017-09-11 |
| 1881112449 | Tess Wianecki | Physician Assistant | 116 S Palisade Dr Ste 110, Santa Maria, CA 93454 | 2017-09-05 |
| 1730603705 | Cac Alvin Center | Counselor | 316 E Mcelhany Ave, Santa Maria, CA 93454 | 2017-08-01 |
| 1174045009 | Peter A. Statti Md Inc. | Pediatrics | 1414 S. Miller St. #12, Santa Maria, CA 93454 | 2017-07-12 |
| 1982143970 | Child Abuse Listening Mediation | Community/Behavioral Health | 210 E. Enos Dr., Ste. A, Santa Maria, CA 93454 | 2017-02-23 |
| 1821531344 | Maria Isabel Lara | Counselor | 210 E Enos Dr, Santa Maria, CA 93454 | 2016-12-01 |
| Find all providers in zip 93454 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104200773 | Coast Valley Worship Center | Clinic/Center | 1414 S Miller St, Ste 10 and 11, Santa Maria, CA 93454-6923 | 2015-07-14 |
| 1376972646 | Amanda Pontis | Clinic/Center | 201 S Miller St, Suite 108, Santa Maria, CA 93454-5233 | 2013-11-06 |
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| 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 | SANTA MARIA |
| Zip Code | 93454 |
Please comment or provide details below to improve the information on IRECOVERY BEHAVIORAL HEALTH CLINIC, LLC.
| 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.