MAGIC HOUSE RECOVERY INC (NPI# 1376140384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376140384 |
| Entity Type | Organization |
| Organization Name | MAGIC HOUSE RECOVERY INC |
| Practice Address |
1001 S Mountvale Ct Anaheim CA 92808-2108 |
| Mailing Address |
1001 Avenida Pico Ste 268 San Clemente CA 92673-6957 |
| Practice Telephone | 9498997750 |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2020-10-02 |
| Authorized Official Name | JACKIE BAHU (CEO) |
| Authorized Official Telephone | 9498997750 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Street Address |
1001 S MOUNTVALE CT |
| City | ANAHEIM |
| State | CA |
| Zip Code | 92808-2108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861970378 | Rebeca Martinez-higareda | Specialist/Technologist | 140 S. Chaparral Ct., Suite 110, Anaheim Hills, CA 92808 | 2018-08-06 |
| 1558875450 | Latshikyan Dental Corporation | Dentist | 8162 E Santa Ana Canyon Rd Suite 104, Anahein, CA 92808 | 2017-11-30 |
| 1083153266 | Jennifer Becker | Social Worker | 1368 S Country Glen Way, Anaheim, CA 92808 | 2017-02-21 |
| 1235573304 | Suzanne Renee Molera | Specialist/Technologist | 160 Old Springs Rd., Ste. 100, Anaheim Hills Speech and Language Center, Anaheim Hills, CA 92808 | 2013-04-19 |
| 1346559317 | Bernadette Pamulo Gonzales | Nurse Practitioner | 197 N. Mohler Drive, Anaheim Hills, CA 92808 | 2010-09-24 |
| 1437485653 | Rebecca M. Maravilla, Od, Inc. | Optometrist | 781 S. Weir Canyon Road, Suite 195, Anaheim, CA 92808 | 2009-10-22 |
| 1710142153 | Chris T Nguyen | Dentist | 911 South Brianna Way, Anaheim, CA 92808 | 2008-07-24 |
| 1619174331 | Raymond Warner | Social Worker | 1900 E. 4th Street, 2nd Floor, Anaheim, CA 92808 | 2007-06-27 |
| 1437271582 | Rebecca Marcia Maravilla | Optometrist | 781 S Weir Canyon Road, Suite 195, Anaheim Hills, CA 92808 | 2007-04-06 |
| 1649327412 | Kimberlee Anne Anne Green | Counselor | 120 S. Fairmont Blvd., Anaheim, CA 92808 | 2007-01-04 |
| Find all providers in zip 92808 | ||||
| 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 |
|---|---|---|---|---|
| 1639719131 | Rebel New Life Treatment Center, LLC. | Substance Abuse Rehabilitation Facility | 2309 E Sycamore St, Anaheim, CA 92806-3020 | 2020-01-13 |
| 1245895192 | Healthcare Services, Inc. | Substance Abuse Rehabilitation Facility | 320a N Wilshire Ave, Anaheim, CA 92801-5825 | 2019-05-07 |
| 1134784085 | Windstone Addiction Centers, Inc | Substance Abuse Rehabilitation Facility | 320b N Wilshire Ave, Anaheim, CA 92801-5825 | 2019-05-07 |
| 1285194167 | It's Time To Recover, Inc. | Substance Abuse Rehabilitation Facility | 1135 W. North St, Anaheim, CA 92801-4393 | 2019-03-25 |
| 1942766944 | Windstone Addiction Centers, Inc | Substance Abuse Rehabilitation Facility | 1300 W Pearl St, Anaheim, CA 92801-5937 | 2019-02-14 |
| 1285199778 | Windstone Addiction Centers, Inc | Substance Abuse Rehabilitation Facility | 1243 W Pearl St, Anaheim, CA 92801-5936 | 2019-02-08 |
| 1275098766 | Windstone Addiction Centers, Inc | Substance Abuse Rehabilitation Facility | 1253 W Pearl St, Anaheim, CA 92801-5936 | 2019-02-08 |
| 1356806848 | Windstone Addiction Centers, Inc | Substance Abuse Rehabilitation Facility | 1243 1/2 W Pearl St, Anaheim, CA 92801-5936 | 2019-02-08 |
| 1396211900 | Imagine Recovery Group | Substance Abuse Rehabilitation Facility | 1247 N Lakeview Ave Ste A, Anaheim, CA 92807-1833 | 2018-10-22 |
| 1295241719 | Rebel Recovery Center | Substance Abuse Rehabilitation Facility | 2029 W Chateau Ave, Anaheim, CA 92804-4410 | 2017-12-20 |
| Find all providers in ANAHEIM | ||||
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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.