OCTLC, INC (NPI# 1003280348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003280348 |
| Entity Type | Organization |
| Organization Name | OCTLC, INC |
| Other Organization Name | SUSTAIN RECOVERY |
| Practice Address |
7888 E Autry Dr Anaheim CA 92808-1306 |
| Mailing Address |
3943 Irvine Blvd #5 Irvine CA 92602-2400 |
| Practice Telephone | 7143633133 |
| Practice Fax Number | 6572364152 |
| Mailing Telephone | 8186362938 |
| Mailing Fax Number | 9493817173 |
| Enumeration Date | 2015-11-24 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | MRS. SAYEH SEYEDFATHI (CFO) |
| Authorized Official Telephone | 8186362938 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
306004787 | CA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| sustain recovery | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 29 Fresco, Irvine, CA 926034103 | 9493817173 | 9493817173 |
| Street Address |
7888 E AUTRY DR |
| City | ANAHEIM |
| State | CA |
| Zip Code | 92808-1306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861970378 | Rebeca Martinez-higareda | Specialist/Technologist | 140 S. Chaparral Ct., Suite 110, Anaheim Hills, CA 92808 | 2018-08-06 |
| 1558875450 | Latshikyan Dental Corporation | Dentist | 8162 E Santa Ana Canyon Rd Suite 104, Anahein, CA 92808 | 2017-11-30 |
| 1083153266 | Jennifer Becker | Social Worker | 1368 S Country Glen Way, Anaheim, CA 92808 | 2017-02-21 |
| 1235573304 | Suzanne Renee Molera | Specialist/Technologist | 160 Old Springs Rd., Ste. 100, Anaheim Hills Speech and Language Center, Anaheim Hills, CA 92808 | 2013-04-19 |
| 1346559317 | Bernadette Pamulo Gonzales | Nurse Practitioner | 197 N. Mohler Drive, Anaheim Hills, CA 92808 | 2010-09-24 |
| 1437485653 | Rebecca M. Maravilla, Od, Inc. | Optometrist | 781 S. Weir Canyon Road, Suite 195, Anaheim, CA 92808 | 2009-10-22 |
| 1710142153 | Chris T Nguyen | Dentist | 911 South Brianna Way, Anaheim, CA 92808 | 2008-07-24 |
| 1619174331 | Raymond Warner | Social Worker | 1900 E. 4th Street, 2nd Floor, Anaheim, CA 92808 | 2007-06-27 |
| 1437271582 | Rebecca Marcia Maravilla | Optometrist | 781 S Weir Canyon Road, Suite 195, Anaheim Hills, CA 92808 | 2007-04-06 |
| 1649327412 | Kimberlee Anne Anne Green | Counselor | 120 S. Fairmont Blvd., Anaheim, CA 92808 | 2007-01-04 |
| Find all providers in zip 92808 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770194060 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 195 S Peralta Hills Dr, Anaheim, CA 92807-3424 | 2020-08-11 |
| 1710371950 | Octlc, Inc. | Substance Abuse Rehabilitation Facility | 125 S Chaparral Ct Ste 200, Anaheim, CA 92808-2263 | 2015-03-25 |
| 1407946304 | Southern California Alcohol & Drug Programs, Inc. | Substance Abuse Rehabilitation Facility | 321 N State College Blvd, Anaheim, CA 92806-2915 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275620 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 80 W Nicasio, San Geronimo, CA 94963 | 2020-11-05 |
| 1013518042 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 1208 Via Aracena, Camarillo, CA 93010-7440 | 2020-11-05 |
| 1609477645 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 1850 Calle Alberca, Camarillo, CA 93010-1811 | 2020-11-05 |
| 1467053736 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 615 Bugeia Ln, Novato, CA 94945-1517 | 2020-11-04 |
| 1376144642 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 100 Avocado Pl, Camarillo, CA 93010-8467 | 2020-11-04 |
| 1285235556 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 7210 Johnston Rd, Pleasanton, CA 94588-9466 | 2020-11-04 |
| 1780282988 | Muir Wood LLC | Substance Abuse Rehabilitation Facility | 2891 I Street Ext, Petaluma, CA 94952-9521 | 2020-10-12 |
| 1720692577 | Muir Wood, LLC. | Substance Abuse Rehabilitation Facility | 1743 Skillman Lane, Petaluma, CA 94952-9495 | 2020-08-31 |
| 1598376816 | Muir Wood LLC | Substance Abuse Rehabilitation Facility | 6868 Cold Springs Rd, Penngrove, CA 94951-9722 | 2020-08-11 |
| 1477161149 | Asian American Drug Abuse Program, Inc | Substance Abuse Rehabilitation Facility | 4625 Crenshaw Blvd, Los Angeles, CA 90043-1209 | 2020-07-20 |
| 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.