SPARKLES KC LLC


Address: 10002 Briley Way, Villa Park, CA 92861-4219
Phone: 9492890350

SPARKLES KC LLC (NPI# 1073962791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1073962791
Entity Type Organization
Organization Name SPARKLES KC LLC
Other Organization Name PATH TO SERENITY
Practice Address 10002 Briley Way
Villa Park
CA 92861-4219
Mailing Address 8 Cheshire Ct
Newport Beach
CA 92660-4210
Practice Telephone 9492890350
Mailing Telephone 9492890350
Enumeration Date 2016-06-03
Last Update Date 2016-06-03
Authorized Official Name MS. IZZY HIRSON (CEO)
Authorized Official Telephone 9492890350
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 324500000X Substance Abuse Rehabilitation Facility Residential Treatment Facilities

Other Provider/Organization Names

Other Name Type Code
Path To Serenity Doing Business As Name - Organization

Office Location

Street Address 10002 BRILEY WAY
City VILLA PARK
State CA
Zip Code 92861-4219

Providers in the same location

NPI Name Taxonomy Address Enumeration
1710411483 Recovery Bay Rehabilitation Center Substance Abuse Rehabilitation Facility 10002 Briley Way, Villa Park, CA 92861-4219 2017-04-19

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1528615127 Jospeh A Ropel Technician 9492 Brynmar Dr, Villa Park, CA 92861 2019-08-20
1982027868 Junn Yann Chang General Practice 9431 Featherhill Dr., Villa Park, CA 92861 2014-01-28
1679830749 Arnold Philip Deutsch Psychiatry & Neurology 10141 Morning Star Circle, Villa Park, CA 92861 2012-04-13
1558594994 Richard Lyle Goldman Obstetrics & Gynecology 18892 Patrician Dr., Villa Park, CA 92861 2009-09-02
1871600395 James Patrick Furcolow Optometrist 17829 Santiago Blvd, Villa Park, CA 92861 2006-08-23
1649540352 Elaine R Collins Marriage & Family Therapist 17817 Santiago Blvd, Villa Park Medical, Villa Park, CA 92861 2012-01-11
1619597671 Harry Eisenbach Family Medicine 9312 Smoketree Ln, Villa Park, CA 92861-1011 2020-04-20
1154668457 Warren Harmon Fox Specialist 9681 Crestview Cir, Villa Park, CA 92861-1311 2013-01-08
1053654269 Kristen Michele Fuller Student in an Organized Health Care Education/Training Program 9461 Featherhill Dr, Villa Park, CA 92861-2613 2013-04-05
1316088529 Sam Joseph Poidmore Dentist 18152 Pamela Pl, Villa Park, CA 92861-2626 2007-02-09
Find all providers in zip 92861

Taxonomy Information

Taxonomy Code 324500000X
Grouping Residential Treatment Facilities
Classification Substance Abuse Rehabilitation Facility

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1710411483 Recovery Bay Rehabilitation Center Substance Abuse Rehabilitation Facility 10002 Briley Way, Villa Park, CA 92861-4219 2017-04-19
1508240268 Recovery Bay Rehabilitation Center, LLC Substance Abuse Rehabilitation Facility 18912 Patrician Dr, Villa Park, CA 92861-4214 2015-07-13

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1801497359 California Care Detox & Treatment Substance Abuse Rehabilitation Facility 25542 Dana Mesa Dr, San Juan Capistrano, CA 92675-4311 2020-11-02
1952900797 A Sacred Path Substance Abuse Rehabilitation Facility 5671 Spanish Flat Rd, Garden Valley, CA 95633 2020-10-22
1467051672 Spearhead Health Centers, LLC. Substance Abuse Rehabilitation Facility 11704 Wilshire Blvd Ste 226, Los Angeles, CA 90025-1504 2020-10-19
1073111613 A Place To Heal Substance Abuse Rehabilitation Facility 14540 Hamlin St Ste H, Van Nuys, CA 91411-4153 2020-10-15
1871191569 Old Oak Ranch Recovery Center Substance Abuse Rehabilitation Facility 19401 Susan Way, Sonora, CA 95370-9266 2020-10-14
1962009845 Apex Recovery, LLC Substance Abuse Rehabilitation Facility 9952 Grandview Dr, La Mesa, CA 91941-6874 2020-10-05
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
Find all providers with the same taxonomy

Competitor

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City VILLA PARK
Zip Code 92861

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Dataset Information

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.

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