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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
Other Name | Type Code |
---|---|
Path To Serenity | Doing Business As Name - Organization |
Street Address |
10002 BRILEY WAY |
City | VILLA PARK |
State | CA |
Zip Code | 92861-4219 |
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 |
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 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 |
---|---|---|---|---|
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 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
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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 |
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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 |
City | VILLA PARK |
Zip Code | 92861 |
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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.