WOODGLEN WEST DETOX (NPI# 1093268849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093268849 |
| Entity Type | Organization |
| Organization Name | WOODGLEN WEST DETOX |
| Practice Address |
1401 W Orangethorpe Ave Fullerton CA 92833-4632 |
| Mailing Address |
771 W Orangethorpe Ave Fullerton CA 92832-2806 |
| Practice Telephone | 7148693270 |
| Mailing Telephone | 7148790929 |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2016-07-28 |
| Authorized Official Name | WALTER P ERICKSON (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 7145782962 |
| Is Organization Subpart | Y |
| Parent Organization Name | WOODGLEN RECOVERY JUNCTION, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 300042DN | CA | Residential Treatment Facilities |
| Street Address |
1401 W ORANGETHORPE AVE |
| City | FULLERTON |
| State | CA |
| Zip Code | 92833-4632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790333565 | Qz Enterpprises Corp | In Home Supportive Care | 2817 Muir Trail Dr, Fullerton, CA 92833 | 2019-08-26 |
| 1780114306 | Acupuncture Nara Inc | Clinic/Center | 2334 W. Valencia Dr., Fullerton, CA 92833 | 2017-06-15 |
| 1518350149 | Young A Lee | Nurse Practitioner | 2529 Monterey Pl, Fullerton, CA 92833 | 2015-03-06 |
| 1538557871 | Annacess Arcadio | Occupational Therapy Assistant | 1437 W Woodcrest Ave, Fullerton, CA 92833 | 2015-01-08 |
| 1710306923 | Nora Edith Heredia | Counselor | 1060 S Brookhurst Road, Fullerton, CA 92833 | 2014-04-15 |
| 1912322892 | Louis Michael Hinzo | Counselor | 1060 S. Brookhurst Rd., Fullerton, CA 92833 | 2014-02-28 |
| 1497011290 | Paul Choong Hwan Lee, M.d. A Medical Corporation | Ophthalmology | 1401 S. Brookhurst Rd., Suite 107, Fullerton, CA 92833 | 2012-04-05 |
| 1992073860 | Tammy Phan | Pharmacist | 1826 W Orangethrope Ave, Fullerton, CA 92833 | 2011-12-07 |
| 1346577160 | Hara Orthotics and Prosthetics,inc | Prosthetic/Orthotic Supplier | 1343 W. Valencia Dr., Suite E, Fullerton, CA 92833 | 2009-11-16 |
| 1265669923 | Marcelle Bonneau Taylor | Marriage & Family Therapist | 1145 W. Valencia Mesa, Emmanuel Episcopal Church, Fullerton, CA 92833 | 2009-06-19 |
| Find all providers in zip 92833 | ||||
| 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 |
|---|---|---|---|---|
| 1003435033 | Resurgence California, LLC | Substance Abuse Rehabilitation Facility | 158 Marion Blvd, Fullerton, CA 92835-3525 | 2020-04-09 |
| 1083075030 | Advance Recovery Solution, LLC | Substance Abuse Rehabilitation Facility | 3744 N Hermosa Pl, Fullerton, CA 92835 | 2016-03-17 |
| 1720249873 | The Sober Zone, Inc | Substance Abuse Rehabilitation Facility | 1308 W Porter Ave, Fullerton, CA 92833-4018 | 2008-06-20 |
| 1043397029 | Woodglen Recovery Junction | Substance Abuse Rehabilitation Facility | 751 W Orangethorpe Ave, Fullerton, CA 92832-2806 | 2006-11-01 |
| 1437244159 | Woodglen Recovery Junction Incorporated | Substance Abuse Rehabilitation Facility | 771 W Orangethorpe Ave, Fullerton, CA 92832-2806 | 2006-10-04 |
| 1134205222 | Woodglen Recovery Junction | Substance Abuse Rehabilitation Facility | 329 E Commonwealth Ave, Fullerton, CA 92832-2016 | 2006-10-31 |
| 1558444901 | Callie Vitale | Substance Abuse Rehabilitation Facility | 771 W Orangethorpe Ave, Fullerton, CA 92832-2806 | 2006-10-21 |
| 1831271386 | Carlos Antonio Isais | Substance Abuse Rehabilitation Facility | 771 W Orangethorpe Ave, Fullerton, CA 92832-2806 | 2006-10-20 |
| 1851480016 | Georgina R Vitale-hansen | Substance Abuse Rehabilitation Facility | 771 W Orangethorpe Ave, Fullerton, CA 92832-2806 | 2006-10-12 |
| 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 | ||||
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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.