OLD OAK RANCH RECOVERY CENTER (NPI# 1871191569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871191569 |
Entity Type | Organization |
Organization Name | OLD OAK RANCH RECOVERY CENTER |
Practice Address |
19401 Susan Way Sonora CA 95370-9266 |
Practice Telephone | 2095886071 |
Mailing Telephone | 2095886071 |
Enumeration Date | 2020-10-14 |
Last Update Date | 2020-10-14 |
Authorized Official Name | CHRISTOPHER KHAN (PRESIDENT) |
Authorized Official Telephone | 2095886071 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
Other Name | Type Code |
---|---|
The Refuge Recovery Center | Doing Business As Name - Organization |
Street Address |
19401 SUSAN WAY |
City | SONORA |
State | CA |
Zip Code | 95370-9266 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174056089 | Chris Neves | Case Management | 427 N Highway 49, Suite 305, Sonora, CA 95370 | 2017-04-07 |
1528433885 | Michael French Dds Dental Corporation | General Acute Care Hospital | 800 Morningstar Dr, Sonora, CA 95370 | 2015-12-11 |
1942681465 | Amanda Evans | Registered Nurse | 20111 Cedar Rd North, Sonor, CA 95370 | 2015-06-10 |
1043625916 | Cicely Chen | Obstetrics & Gynecology | 900 Greenley Rd, Suite 922 Adventist Health (sierra Ob/, Sonora, CA 95370 | 2014-06-30 |
1457781692 | Donnie E Campbell | Homeopath | 63 South Stewart St, Sonora, CA 95370 | 2013-11-26 |
1386078186 | Jo Ann M Rascon | Marriage & Family Therapist | 38 N Washington St, Suite F, Sonora, CA 95370 | 2013-08-28 |
1831449735 | Sami Rhodes | Case Manager/Care Coordinator | 427 N. Highway 49, Sonora, CA 95370 | 2012-09-18 |
1619225273 | Melissa Parrish | Registered Nurse | 20111 Cedar Rd. North, Sonora, CA 95370 | 2012-08-29 |
1295033504 | Magdalena Martinez Bauman | Marriage & Family Therapist | 175 Fairview Ln., Sonora, CA 95370 | 2011-03-10 |
1588804215 | Holly Gwendolyn Harris | Physical Therapist | 15274 Camino Del Parque Rd. S, Sonora, CA 95370 | 2009-02-20 |
Find all providers in zip 95370 |
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] |
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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 |
1760099394 | Northridge Addiction Treatment Center LLC | Substance Abuse Rehabilitation Facility | 9450 Tampa Ave, Northridge, CA 91324-2746 | 2020-09-28 |
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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.