BRYAN'S HOUSE RECOVERY HOME (NPI# 1275001067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275001067 |
Entity Type | Organization |
Organization Name | BRYAN'S HOUSE RECOVERY HOME |
Practice Address |
2000 Traffic Way Atascadero CA 93422-1523 |
Mailing Address |
7760 Whispering Trails Pl Paso Robles CA 93446-6396 |
Practice Telephone | 8054606621 |
Practice Fax Number | 8663065825 |
Mailing Telephone | 8056743131 |
Mailing Fax Number | 8663065825 |
Enumeration Date | 2018-11-09 |
Last Update Date | 2018-12-07 |
Authorized Official Name | SANDRA LEE WORTLEY (CEO/EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 8056743131 |
Authorized Official Credential | CCAPP LCI0470031 |
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 |
Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | 1093914152 | 05 |
Street Address |
2000 TRAFFIC WAY |
City | ATASCADERO |
State | CA |
Zip Code | 93422-1523 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093914152 | Sandy Lea Wortley | Counselor | 2000 Traffic Way, Atascadero, CA 93422-1523 | 2007-07-17 |
1710524160 | Kastina Rae Moore | Counselor | 2000 Traffic Way, Atascadero, CA 93422-1523 | 2019-12-04 |
1235498353 | Jennifer Ann Gustavson-dufour | Marriage & Family Therapist | 2000 Traffic Way, Atascadero, CA 93422-1523 | 2012-05-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356903645 | Michael E Nevin | Licensed Psychiatric Technician | 6550 Morro Rd, Unit D, Atascadero, CA 93422 | 2019-07-08 |
1225495583 | Kelly Michelle Morrow | Counselor | 7130 Sombrilla Ave., Atascadero, CA 93422 | 2016-01-18 |
1609242817 | Cheyenne M Britton | Counselor | 9366 Ribereng Circle, Atascadero, CA 93422 | 2015-08-12 |
1033590856 | Debra Marie Califia | Counselor | 6500 Morro Rd., Aegis Treatment Centers, Atascadero, CA 93422 | 2015-06-17 |
1134548498 | Allison Muller | Counselor | 8000 Santa Rosa Road, Atascadero, CA 93422 | 2014-04-15 |
1376973875 | Jana Slezakova | Psychologist | 10333 El Camino Real Dept Of, Atascadero, CA 93422 | 2013-11-19 |
1013341189 | Kimberly L Schwab | Counselor | 5575 Hospital Dr., Atascadero, CA 93422 | 2013-08-26 |
1982941274 | Krisitana Lynn Hatcher Miller | Counselor | 6312 Atascadero Ave, Atascadero, CA 93422 | 2013-01-07 |
1588939995 | Else Mai Thi Curry | Counselor | 4000 Santa Cruz Rd, Atascadero, CA 93422 | 2012-03-19 |
1083987523 | Kathryn Gaoiran Bartlett | Pharmacist | 8200 El Camino Real, Atascadero, CA 93422 | 2012-02-14 |
Find all providers in zip 93422 |
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] |
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---|---|---|---|---|
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 |
1770194060 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 195 S Peralta Hills Dr, Anaheim, CA 92807-3424 | 2020-08-11 |
Find all providers with the same taxonomy |
City | ATASCADERO |
Zip Code | 93422 |
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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.