FOUNTAIN RECOVERY (NPI# 1497984744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497984744 |
| Entity Type | Organization |
| Organization Name | FOUNTAIN RECOVERY |
| Practice Address |
4049 1st St Ste 123 Livermore CA 94551-4949 |
| Practice Telephone | 9252925583 |
| Mailing Telephone | 9252925583 |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2018-02-22 |
| Authorized Official Name | NATASHA ARCHULETA (OWNER) |
| Authorized Official Telephone | 9252925583 |
| Is Organization Subpart | Y |
| Parent Organization Name | BROTHER AND SISTER PARTNERSHIP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 010095AP | CA | Residential Treatment Facilities |
| Street Address |
4049 1ST ST STE 123 |
| City | LIVERMORE |
| State | CA |
| Zip Code | 94551-4949 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700370897 | Mauricio Perez De La Vega Sr. | Behavioral Analyst | 564 Heligan Ln Unit 3, Livermore, CA 94551 | 2018-06-21 |
| 1528592003 | Angel Qin | Pharmacist | 7 Meritage Common, Unit 203, Livermore, CA 94551 | 2017-04-12 |
| 1538690169 | Pradeepkumar R Patel | Pharmacist | 300-g Pullman Street, Livermore, CA 94551 | 2017-03-24 |
| 1306398987 | Janella Rae Palao Bautista | Counselor | Sierra School At Livermore (lawerence Elementary), 2451 Portola Ave, Livermore, CA 94551 | 2016-10-28 |
| 1255887006 | Eye Candy, L.L.C. | Optometrist | 4423 First Street, Livermore, CA 94551 | 2016-08-31 |
| 1144675869 | Aic Health Care Inc. | Home Health | 4049 First St Ste 229, Livermore, CA 94551 | 2016-05-02 |
| 1376943704 | Danielle Leduc | Social Worker | 6112 Water Lily Cmns Apt 107, Livermore, CA 94551 | 2014-09-04 |
| 1326463597 | Anka Behavioral Health, Inc. | Community/Behavioral Health | 2177 Las Positas Ct Ste Bc, Livermore, CA 94551 | 2014-02-25 |
| 1285055939 | Tram Hoa Huynh | Pharmacist | 300 Pullman St., Livermore, CA 94551 | 2013-12-26 |
| 1902146806 | Amy Suezaki | Pharmacist | 300a Pullman St, Livermore, CA 94551 | 2013-03-01 |
| Find all providers in zip 94551 | ||||
| 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 |
|---|---|---|---|---|
| 1225337033 | Axis Community Health Inc. | Substance Abuse Rehabilitation Facility | 446 Lindbergh Ave, Livermore, CA 94551-9552 | 2011-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497359 | California Care Detox & Treatment | Substance Abuse Rehabilitation Facility | 25542 Dana Mesa Dr, San Juan Capistrano, CA 92675-4311 | 2020-11-02 |
| 1952900797 | A Sacred Path | Substance Abuse Rehabilitation Facility | 5671 Spanish Flat Rd, Garden Valley, CA 95633 | 2020-10-22 |
| 1467051672 | Spearhead Health Centers, LLC. | Substance Abuse Rehabilitation Facility | 11704 Wilshire Blvd Ste 226, Los Angeles, CA 90025-1504 | 2020-10-19 |
| 1073111613 | A Place To Heal | Substance Abuse Rehabilitation Facility | 14540 Hamlin St Ste H, Van Nuys, CA 91411-4153 | 2020-10-15 |
| 1871191569 | Old Oak Ranch Recovery Center | Substance Abuse Rehabilitation Facility | 19401 Susan Way, Sonora, CA 95370-9266 | 2020-10-14 |
| 1962009845 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 9952 Grandview Dr, La Mesa, CA 91941-6874 | 2020-10-05 |
| 1376140384 | Magic House Recovery Inc | Substance Abuse Rehabilitation Facility | 1001 S Mountvale Ct, Anaheim, CA 92808-2108 | 2020-10-02 |
| 1942807060 | New Perceptions North, LLC | Substance Abuse Rehabilitation Facility | 5084 N Fruit Ave Ste 105, Fresno, CA 93711-3000 | 2020-10-01 |
| 1346857679 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 3480 Hidden Trail Dr, Jamul, CA 91935-2104 | 2020-09-30 |
| 1992312227 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 2810 Camino Del Rio S Ste 106, San Diego, CA 92108-3819 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
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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.