DESTINY RECOVERY CENTER IOP (NPI# 1356860738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1356860738 |
Entity Type | Organization |
Organization Name | DESTINY RECOVERY CENTER IOP |
Other Organization Name | DETINY RECOVERY CENTER IOP |
Practice Address |
23041 Avenida De La Carlota Ste 280 Laguna Hills CA 92653-1531 |
Practice Telephone | 8777062650 |
Mailing Telephone | 8777062650 |
Enumeration Date | 2017-09-17 |
Last Update Date | 2017-09-17 |
Authorized Official Name | MR. MORDECHAI RUBIN (OWNER) |
Authorized Official Telephone | 8777062650 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR0401X |
Clinic/Center Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
300377AP | CA | Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
DETINY RECOVERY CENTER IOP | Doing Business As Name - Organization |
Street Address |
23041 AVENIDA DE LA CARLOTA STE 280 |
City | LAGUNA HILLS |
State | CA |
Zip Code | 92653-1531 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932708476 | Nikkie Veyseh | Behavior Technician | 26921 Falling Leaf Dr., Laguna Hills, CA 92653 | 2020-10-24 |
1609480425 | Steve Ceja | Behavior Technician | 25201 Paseo De Alicia Suite 110, Laguna Hills, CA 92653 | 2020-08-31 |
1467006882 | Kristina Alexa Puno Morales | Dietitian, Registered | 24552 Health Center Drive, Laguna Hills, CA 92653 | 2019-07-25 |
1164929626 | Shoreline Consulting Services, Inc. | Clinic/Center | 23010 Lake Forest Drive, Suite B, Laguna Hills, CA 92653 | 2018-04-11 |
1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
1831613850 | Stephani A Berg | Physical Medicine & Rehabilitation | 24422 Avenida De La Carlota Suite 190, Laguna Hills, CA 92653 | 2017-08-01 |
1497299945 | Stephanie Lyle | Nurse Practitioner | 24221 Calle De Louisa, Suite 400, Laguna Hills, CA 92653 | 2016-12-16 |
1053776278 | Meillanny Gladness | Counselor | 23151 Verdugo Dr Ste 203, Laguna Hills, CA 92653 | 2015-12-16 |
1912383183 | Pmdca, LLC | Clinical Medical Laboratory | 23297 S Pointe Dr Ste 100, Laguna Hills, CA 92653 | 2015-08-10 |
1821486630 | 4mpw, Inc. | Home Health | 23232 Peralta Drive 216, Laguan Hills, CA 92653 | 2014-12-31 |
Find all providers in zip 92653 |
Taxonomy Code | 261QR0401X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
Definition to come... |
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1073966370 | New U Beginnings Inc | Clinic/Center | 5205 Agnes Ave, Valley Village, CA 91607-2701 | 2016-07-21 |
1659731479 | Options, LLC | Clinic/Center | 2790 Harbor Blvd Ste 307, Costa Mesa, CA 92626-5157 | 2016-03-07 |
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City | LAGUNA HILLS |
Zip Code | 92653 |
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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.