HELEN VINE RECOVERY CENTER (NPI# 1003206228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003206228 |
| Entity Type | Organization |
| Organization Name | HELEN VINE RECOVERY CENTER |
| Practice Address |
291 Smith Ranch Rd San Rafael CA 94903-5551 |
| Mailing Address |
555 Northgate Dr Ste 100 San Rafael CA 94903-3696 |
| Practice Telephone | 4154920818 |
| Mailing Telephone | 4154576964 |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2018-05-01 |
| Authorized Official Name | JAMES MENSING (DIRECTOR - QUALITY & COMPLIANCE) |
| Authorized Official Telephone | 4153021423 |
| Is Organization Subpart | Y |
| Parent Organization Name | BUCKELEW PROGRAMS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 210017DN | CA | Residential Treatment Facilities |
| Street Address |
291 SMITH RANCH RD |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94903-5551 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861032161 | Parnian Djafarzadeh Smith | Counselor | 291 Smith Ranch Rd, San Rafael, CA 94903-2093 | 2020-01-14 |
| 1154967842 | David Myers | Counselor | 291 Smith Ranch Rd, San Rafael, CA 94903-2093 | 2019-11-18 |
| 1538630793 | William Matthew Smith | Counselor | 291 Smith Ranch Rd, San Rafael, CA 94903-2093 | 2018-12-16 |
| 1700357969 | Corey Brown | Counselor | 291 Smith Ranch Rd, San Rafael, CA 94903-2093 | 2018-12-16 |
| 1043781206 | Marianne Lambrecht | Counselor | 291 Smith Ranch Rd, San Rafael, CA 94903-2093 | 2018-12-16 |
| 1861963027 | Jamie J Baylis | Counselor | 291 Smith Ranch Rd, San Rafael, CA 94903-2093 | 2018-12-16 |
| 1326519406 | Karlan Donald Brooks | Counselor | 291 Smith Ranch Rd, San Rafael, CA 94903-2093 | 2018-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467089524 | Christopher Sazo | Counselor | 1 St. Vincents Drive, San Rafael, CA 94903 | 2020-03-26 |
| 1134769482 | Katherine Sieger | Music Therapist | 400 Civic Center Dr. #300, San Rafael, CA 94903 | 2020-01-14 |
| 1679064836 | California In Home Care & Registry, Inc | In Home Supportive Care | 14b Mitchell Blvd, Suite B, San Rafael, CA 94903 | 2018-05-23 |
| 1922557586 | Helen Elizabeth Shamis | Marriage & Family Therapist | 30 North San Pedro, Suite #265, Beyond Hunger, San Rafael, CA 94903 | 2016-09-23 |
| 1033572771 | Henry Colbert | Counselor | 1 St. St. Vincent Drive, San Rafael, CA 94903 | 2016-03-31 |
| 1659736924 | Robyn Bloom | Marriage & Family Therapist | 4 Joseph Court, San Rafael, CA 94903 | 2015-12-30 |
| 1851760565 | Cheryl Clementson | Substance Abuse Rehabilitation Facility | 301 Smith Ranch Road, San Rafael, CA 94903 | 2015-09-23 |
| 1588043731 | Chelsea Cooney | Counselor | 1 St. Vincent's Drive, San Rafael, CA 94903 | 2015-05-20 |
| 1083002315 | Kaiser Permanente | Psychiatric Unit | 111 Smith Ranch Road, Kaiser Permanente, San Rafael, CA 94903 | 2015-01-09 |
| 1366857856 | Travel Well Corporation | Preventive Medicine | 28 Mitchell Blvd, San Rafael, CA 94903 | 2014-06-24 |
| Find all providers in zip 94903 | ||||
| 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 |
|---|---|---|---|---|
| 1982246815 | Ca Ya Services LLC | Substance Abuse Rehabilitation Facility | 285 Margarita Dr, San Rafael, CA 94901-2329 | 2019-10-11 |
| 1851760565 | Cheryl Clementson | Substance Abuse Rehabilitation Facility | 301 Smith Ranch Road, San Rafael, CA 94903 | 2015-09-23 |
| 1295104420 | Robert Bostonian | Substance Abuse Rehabilitation Facility | 67 Grande Paseo, San Rafael, CA 94903-1555 | 2015-09-17 |
| 1982071833 | Brian Finley | Substance Abuse Rehabilitation Facility | 195 Nova Albion Way Apt 21, San Rafael, CA 94903-4528 | 2015-08-26 |
| 1669716361 | North Bay Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 55 Shaver St, San Rafael, CA 94901-2787 | 2012-11-19 |
| 1801041074 | Bayside Marin, LLC | Substance Abuse Rehabilitation Facility | 718 4th St, San Rafael, CA 94901-3213 | 2008-12-01 |
| 1316169576 | Center Point, Inc. | Substance Abuse Rehabilitation Facility | 39 Mary St, San Rafael, CA 94901-3451 | 2007-05-03 |
| 1235351487 | Center Point, Inc. | Substance Abuse Rehabilitation Facility | 519 Belle Ave, San Rafael, CA 94901-3414 | 2007-05-03 |
| 1760601355 | Center Point, Inc. | Substance Abuse Rehabilitation Facility | 812 D St, San Rafael, CA 94901-2814 | 2007-04-24 |
| 1851510440 | Center Point, Inc | Substance Abuse Rehabilitation Facility | 1477 Lincoln Ave, San Rafael, CA 94901-2028 | 2007-04-24 |
| Find all providers in SAN RAFAEL | ||||
| City | SAN RAFAEL |
| Zip Code | 94903 |
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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.