FIRST LIGHT RECOVERY (NPI# 1568830081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568830081 |
| Entity Type | Organization |
| Organization Name | FIRST LIGHT RECOVERY |
| Practice Address |
140 Avenida Algodon San Clemente CA 92627 |
| Mailing Address |
140 Avenida Algodon San Clemente CA 92672-4182 |
| Practice Telephone | 9492945104 |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2015-09-15 |
| Authorized Official Name | MELODY JOY STONE (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 9492945104 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 300325AP | CA | Residential Treatment Facilities |
| Street Address |
140 AVENIDA ALGODON |
| City | SAN CLEMENTE |
| State | CA |
| Zip Code | 92627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275783755 | Willa Lilly Brinkley | General Practice | 140 Avenida Algodon, San Clemente, CA 92672-4182 | 2008-09-22 |
| 1174157358 | Jennifer Lynn Devore | Marriage & Family Therapist | 140 Avenida Algodon, San Clemente, CA 92672-4182 | 2020-02-26 |
| 1922531359 | Stone River Group | Substance Abuse Rehabilitation Facility | 140 Avenida Algodon, Unit A, San Clemente, CA 92672-4182 | 2017-04-03 |
| 1629345590 | Global Nutraceuticals, Inc | Clinic/Center | 140 Avenida Algodon, Unit B, San Clemente, CA 92672-4182 | 2011-11-21 |
| 1154627925 | Physician Nutraceutical Research, Inc | Substance Abuse Rehabilitation Facility | 140 Avenida Algodon, #a, B & C, San Clemente, CA 92672-4182 | 2011-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407174 | Ryan Allen Merrell | Technician | 313 E. 17th Pl #l Costa Mesa, Costa Mesa, CA 92627 | 2020-11-04 |
| 1245703412 | Allure Transportation | Non-emergency Medical Transport (VAN) | 1835 Newport Blvd Ste 109 #110, Costa Mesa, CA 92627 | 2019-01-09 |
| 1750857686 | Living Success Center | Marriage & Family Therapist | 445 E. 17th Street, Suites D & E, Costa Mesa, CA 92627 | 2018-10-18 |
| 1790298909 | Akua Behavioral Health, Inc | Substance Abuse Rehabilitation Facility | 319-a University Drive, Costa Mesa, CA 92627 | 2017-11-09 |
| 1679086862 | Akua Behavioral Health, Inc | Substance Abuse Rehabilitation Facility | 319-b University Drive, Costa Mesa, CA 92627 | 2017-11-09 |
| 1245759018 | Surgical Assistant Associates | Clinic/Center | 186 E. 16th Street, Suite C, Costa Mesa, CA 92627 | 2017-09-13 |
| 1366962334 | Guadalupe A. Mejia Dental Corp. | Dentist | 700 W 19th St., Suite C, Costa Mesa, CA 92627 | 2017-06-21 |
| 1386189033 | Jian Yi Ye | Acupuncturist | 2488 Newport Blvd Ste B1, Costa Mesa, CA 92627 | 2017-01-04 |
| 1144764606 | Michele Marie Patton | Dental Hygienist | 2220 Fairview Rd., Costa Mesa, CA 92627 | 2016-12-18 |
| 1881148500 | Valerie Nguyen | Pharmacist | 1835 Newport Blvd # C, Costa Mesa, CA 92627 | 2016-08-10 |
| Find all providers in zip 92627 | ||||
| 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 | 92627 |
Please comment or provide details below to improve the information on FIRST LIGHT RECOVERY.
| 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.