IMPACT RECOVERY & PSYCHOTHERAPY (NPI# 1164907234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164907234 |
| Entity Type | Organization |
| Organization Name | IMPACT RECOVERY & PSYCHOTHERAPY |
| Practice Address |
28202 Cabot Rd Ste 373 Laguna Niguel CA 92677-1222 |
| Mailing Address |
Po Box 1449 San Juan Capistrano CA 92693-1449 |
| Practice Telephone | 7143985874 |
| Practice Fax Number | 9492482870 |
| Mailing Telephone | 9492487800 |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2018-09-25 |
| Authorized Official Name | TIFFANY BUELL (BILLING MANAGER) |
| Authorized Official Telephone | 9492487800 |
| Authorized Official Credential | CMRS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251V00000X | Voluntary or Charitable | Agencies | ||
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| N | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities | ||
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Street Address |
28202 CABOT RD STE 373 |
| City | LAGUNA NIGUEL |
| State | CA |
| Zip Code | 92677-1222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114566049 | Amber Kramer | Physical Therapist | 30100 Town Center Drive #yz, Laguna Niguel, CA 92677 | 2019-12-23 |
| 1811548340 | Morgan Peikar | Rehabilitation Hospital | 28441 Springfield Dr, Laguna Niguel, CA 92677 | 2019-09-25 |
| 1871056382 | Jacqueline Evamarie Serrano | Chiropractor | 28062 Forbes Road, Laguna Niguel, CA 92677 | 2019-04-11 |
| 1316408859 | Azadeh Ghafari | Social Worker | 30100 Town Center Dr # 179, Laguna Niguel, CA 92677 | 2019-03-27 |
| 1346741857 | Diana Wang | Physical Medicine & Rehabilitation | 30100 Town Center Drive Suite, Suite Yz, Laguna Niguel, CA 92677 | 2018-02-21 |
| 1750833554 | James H. Tran Dds, Dental Corp. | Dentist | 23876 Aliso Creek Road, Laguna Niguel, CA 92677 | 2016-10-27 |
| 1215486139 | Kevin Sun | Dentist | 49 Blue Horizon, Laguna Niguel, CA 92677 | 2016-10-04 |
| 1740637842 | Michael Dacosta | Dentist | 28862 Calle Vista, Laguna Niguel, CA 92677 | 2016-05-18 |
| 1235590373 | Adrian Gomez | Counselor | 24361 Nugget Falls Ln, Laguna Niguel, CA 92677 | 2016-03-17 |
| 1427455906 | Gracie Heart Home Health LLC | Home Health | 24318 El Pilar, Laguna Niguel, CA 92677 | 2014-11-26 |
| Find all providers in zip 92677 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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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 | LAGUNA NIGUEL |
| Zip Code | 92677 |
Please comment or provide details below to improve the information on IMPACT RECOVERY & PSYCHOTHERAPY.
| 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.