INDEVO, INC. (NPI# 1306265772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306265772 |
| Entity Type | Organization |
| Organization Name | INDEVO, INC. |
| Other Organization Name | INDEVO TREATMENT PARTNERS |
| Practice Address |
17900 Sky Park Cir Ste 100 Irvine CA 92614-6471 |
| Practice Telephone | 8555110855 |
| Mailing Telephone | 8555110855 |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2014-04-14 |
| Authorized Official Name | DR. EHSAN GHARADJEDAGHI (CEO) |
| Authorized Official Telephone | 9493102993 |
| Authorized Official Credential | PSYD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 999999 | CA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| INDEVO Treatment Partners | Doing Business As Name - Organization |
| Street Address |
17900 SKY PARK CIR STE 100 |
| City | IRVINE |
| State | CA |
| Zip Code | 92614-6471 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396352944 | Irvine Surgical Center LLC | Clinic/Center | 17624 Redhill Ave Ste B, Irvine, CA 92614 | 2020-09-28 |
| 1245843572 | Jose Raul Sanchez IIi | Behavior Technician | 1063 Mcgraw Ave, Irvine, CA 92614 | 2020-08-26 |
| 1548871064 | Angelina Renee Armenta | Behavior Technician | 1063 Mcgraw Avenue, Suite 100, Irvine, CA 92614 | 2020-08-10 |
| 1083267827 | Jd Health LLC | Durable Medical Equipment & Medical Supplies | 18003 Sky Park Circle, Suite B-c, Irvine, CA 92614 | 2019-07-22 |
| 1326609280 | Abigail Briana Lozano-flores | Behavior Technician | 18008 Sky Park Circle, Suite 110, Irvine, CA 92614 | 2019-06-21 |
| 1770085235 | Heather M. Ayala | Dietitian, Registered | 17985 Sky Park Circle Suite A, Irvine, CA 92614 | 2018-03-01 |
| 1598266033 | Camille Plumbar | Chiropractor | 17811 Skypark Circle, Suite E, Irvine, CA 92614 | 2018-02-21 |
| 1952812448 | Mary M Ahmadian | Nurse Practitioner | Global Transitional Care Suite 100, 2 Executive Circle, Irvine, CA 92614 | 2017-10-24 |
| 1134656804 | Reza Abaei Tafreshi | Dentist | 3 Pazzi, Irvine, CA 92614 | 2017-05-12 |
| 1467991307 | Laboratory Medicine Consultants In Diagnostics | Medical Genetics | 1565 A Mcgaw Ave, Irvine, CA 92614 | 2017-02-13 |
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| 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] |
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| 1720264963 | Morningside Recovery, LLC | Substance Abuse Rehabilitation Facility | 1400 Reynolds Ave, Irvine, CA 92614 | 2008-01-17 |
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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.