PURE LIFE RECOVERY (NPI# 1225422066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225422066 |
| Entity Type | Organization |
| Organization Name | PURE LIFE RECOVERY |
| Practice Address |
1 Calle Saltamontes San Clemente CA 92673-7004 |
| Mailing Address |
1620 Central Ave Suite 202 Cheyenne WY 82001-4557 |
| Practice Telephone | 9493935033 |
| Enumeration Date | 2015-03-18 |
| Last Update Date | 2015-03-18 |
| Authorized Official Name | JEFFREY WILHITE (PRESIDENT) |
| Authorized Official Telephone | 9498990895 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 291U00000X | Clinical Medical Laboratory | CA | Laboratories | |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
300308BP | CA | Behavioral Health & Social Service Providers |
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 300308BP | CA | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215443940 | Pure Life Recovery | Substance Abuse Rehabilitation Facility | 14218 S Canyon Vine Cv, Draper, UT 84020-5631 | 2017-12-18 |
| Street Address |
1 CALLE SALTAMONTES |
| City | SAN CLEMENTE |
| State | CA |
| Zip Code | 92673-7004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497246474 | Cynthia Hull Warren | Nutritionist | 2027 Via Concha, San Clemente, CA 92673 | 2018-05-24 |
| 1063942688 | Trinh T Tran | Pharmacist | 638 Camino De Los Mares #d5, San Clemente, CA 92673 | 2017-06-15 |
| 1427421791 | Jessica A Currens | Nurse Practitioner | 1001 Avenida Pico Ste C517, San Clemente, CA 92673 | 2015-11-08 |
| 1184010647 | Garrett Bryon Rubio | Student in an Organized Health Care Education/Training Program | 905 Calle Amanecer Ste. 265, San Clemente, CA 92673 | 2015-04-11 |
| 1255733853 | Body Mind Spirit Iop Inc | Psychologist | 665 Camino De Los Mares Ste 104, San Clemente, CA 92673 | 2014-09-25 |
| 1548677438 | Jessica Ann Riley | Dermatology | 1300 Avenida Vista Hermosa Ste 150, San Clemente, CA 92673 | 2014-07-13 |
| 1427398718 | Veena Menda | Specialist | 2232 Calle Opalo, San Clemente, CA 92673 | 2013-02-22 |
| 1124383781 | Alexandra Rose Corporation | Substance Abuse Rehabilitation Facility | 4009 Calle Abril, San Clemente, CA 92673 | 2012-07-10 |
| 1457612574 | Noelle J Deckman | Psychologist | 629 Camino De Los Mares Ste 207a, San Clemente, CA 92673 | 2012-06-05 |
| 1851686471 | Meighan Bartholomew Merono | Pharmacist | 990 Avenida Vista Hermosa, San Clemente, CA 92673 | 2011-06-10 |
| Find all providers in zip 92673 | ||||
| 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 |
|---|---|---|---|---|
| 1366003378 | New Method Wellness, Inc. | Substance Abuse Rehabilitation Facility | 313 Calle Villario, San Clemente, CA 92672-2212 | 2019-06-21 |
| 1447767330 | Sobertec LLC | Substance Abuse Rehabilitation Facility | 402 Pasadena Ct, San Clemente, CA 92672-5477 | 2018-01-02 |
| 1750898763 | Sobertec LLC | Substance Abuse Rehabilitation Facility | 4425 Mar Escarpa, San Clemente, CA 92673-6412 | 2017-12-29 |
| 1871941583 | Socal Detox, LLC | Substance Abuse Rehabilitation Facility | 835 Avenida Salvador, San Clemente, CA 92672-2322 | 2016-06-03 |
| 1912355850 | The House of The Rising Son | Substance Abuse Rehabilitation Facility | 521 W Avenida De Los Lobos Marinos, San Clemente, CA 92672-4374 | 2016-06-01 |
| 1093185753 | Luminance Health Group, Inc. | Substance Abuse Rehabilitation Facility | 1804 Via Sage, San Clemente, CA 92673-3710 | 2015-10-06 |
| 1851760938 | Kool Living Inc. | Substance Abuse Rehabilitation Facility | 449 Avenida Crespi, San Clemente, CA 92672-3331 | 2015-09-18 |
| 1528446044 | Pain Recovery Medical Group | Substance Abuse Rehabilitation Facility | 243 Avenida La Cuesta, San Clemente, CA 92672-2140 | 2015-05-16 |
| 1881072304 | Kool Living, Inc. | Substance Abuse Rehabilitation Facility | 4014 Calle Bienvenidos, San Clemente, CA 92672-2610 | 2015-05-16 |
| 1932504024 | Sobertec LLC | Substance Abuse Rehabilitation Facility | 610 Avenida Acapulco, San Clemente, CA 92672-2461 | 2014-10-31 |
| Find all providers in SAN CLEMENTE | ||||
| City | SAN CLEMENTE |
| Zip Code | 92673 |
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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.