EMPIRE HOTEL ALCOHOLIC REHABILITION INC. (NPI# 1619178514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1619178514 |
Entity Type | Organization |
Organization Name | EMPIRE HOTEL ALCOHOLIC REHABILITION INC. |
Other Organization Name | EMPIRE OUTPATIENT SERVICES |
Practice Address |
5014 Shasta Dam Blvd. Shasta Lake City CA 96019-0777 |
Mailing Address |
1237 California St Redding CA 96001-0618 |
Practice Telephone | 5302751076 |
Practice Fax Number | 5302753717 |
Mailing Telephone | 5302437470 |
Mailing Fax Number | 5302437477 |
Enumeration Date | 2007-05-29 |
Last Update Date | 2020-08-22 |
Authorized Official Name | PATRICIA A NEALY (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 5302437470 |
Authorized Official Credential | CASII CADCII |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
450001AN | CA | Ambulatory Health Care Facilities |
Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
450001BN | CA | Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Empire Outpatient Services | Other Name - Individual/Organization |
Street Address |
5014 SHASTA DAM BLVD. |
City | SHASTA LAKE CITY |
State | CA |
Zip Code | 96019-0777 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902958077 | John Douglas Russell | Dentist | 4178 Ashby Court, Shasta Lake City, CA 96019 | 2007-01-17 |
1598739062 | North Valley Developmental Services Inc | Intermediate Care Facility, Mentally Retarded | Walker Lane, Shasta Lake City, CA 96019 | 2006-02-14 |
1194869883 | Terry D Kinney | Physician Assistant | 645 Antelope Blvd, Suite # 24, Red Bluff, CA 96019 | 2007-02-16 |
1538209572 | Patrick O'learly | Marriage & Family Therapist | 17682 Yellow Pine Ave, Shasta Lake, CA 96019-2074 | 2007-02-07 |
1649364399 | Steve Swirsky | Durable Medical Equipment & Medical Supplies | 4103 Pembroke Ln, Shasta Lake, CA 96019-2409 | 2006-10-03 |
1215920319 | Ronald G Chambers I | Family Medicine | 4174 Ashby Ct, Shasta Lake, CA 96019-9215 | 2005-08-24 |
1831724053 | Redding Rancheria | Clinic/Center | 4174 Ashby Ct, Shasta Lake, CA 96019-9215 | 2020-03-09 |
1861616567 | Ronald G Chambers Inc | Family Medicine | 4174 Ashby Ct, Shasta Lake, CA 96019-9215 | 2007-04-12 |
1093883555 | The Cornerstone Recovery Systems, Inc. | Substance Abuse Rehabilitation Facility | 2096 Cascade Blvd, Shasta Lake, CA 96019-9308 | 2006-12-01 |
1457706392 | Cascades Management Company | Community Based Residential Treatment Facility, Mental Illness | 2096 Cascade Blvd, Shasta Lake, CA 96019-9308 | 2016-04-28 |
Find all providers in zip 96019 |
Taxonomy Code | 261QR0405X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rehabilitation, Substance Use Disorder |
Definition to come... |
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City | SHASTA LAKE CITY |
Zip Code | 96019 |
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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.