WATERFRONT RECOVERY SERVICES (NPI# 1417307125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417307125 |
Entity Type | Organization |
Organization Name | WATERFRONT RECOVERY SERVICES |
Other Organization Name | WATERFRONT RECOVERY SERVICES |
Practice Address |
2413 2nd St Eureka CA 95501-0811 |
Mailing Address |
2109 Broadway Ste A Eureka CA 95501-2106 |
Practice Telephone | 7072699590 |
Practice Fax Number | 7074452599 |
Mailing Telephone | 7074451391 |
Mailing Fax Number | 7074452599 |
Enumeration Date | 2016-06-14 |
Last Update Date | 2017-11-13 |
Authorized Official Name | JOHN BERNARD MCMANUS (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 7074451391 |
Authorized Official Credential | CATC |
Is Organization Subpart | Y |
Parent Organization Name | ALCOHOL DRUG CARE SERVICES,INC. |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 324500000X | Substance Abuse Rehabilitation Facility | 120009AN | CA | Residential Treatment Facilities |
Other Name | Type Code |
---|---|
Waterfront Recovery Services | Doing Business As Name - Organization |
Street Address |
2413 2ND ST |
City | EUREKA |
State | CA |
Zip Code | 95501-0811 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790821833 | Jana Moser | Marriage & Family Therapist | 2413 2nd St, Eureka, CA 95501-0811 | 2007-01-29 |
1437615879 | Everett Douglas Allen | Internal Medicine | 2413 2nd St, Eureka, CA 95501-0811 | 2019-02-11 |
1164818068 | Jasmin Jimenez | Student in an Organized Health Care Education/Training Program | 2413 2nd St, Eureka, CA 95501-0811 | 2015-04-08 |
1306237631 | Carrie Collins | Case Manager/Care Coordinator | 2413 2nd St, Eureka, CA 95501-0811 | 2015-02-09 |
1487042156 | Candis Danielson | Case Manager/Care Coordinator | 2413 2nd St, Eureka, CA 95501-0811 | 2015-01-05 |
1689070740 | Marie Milano | Case Manager/Care Coordinator | 2413 2nd St, Eureka, CA 95501-0811 | 2014-11-17 |
1558770313 | Lindsay Stout | Case Manager/Care Coordinator | 2413 2nd St, Eureka, CA 95501-0811 | 2014-08-06 |
1619385903 | Forrest Hale | Case Manager/Care Coordinator | 2413 2nd St, Eureka, CA 95501-0811 | 2014-07-30 |
1417362062 | Joanna Moore | Case Manager/Care Coordinator | 2413 2nd St, Eureka, CA 95501-0811 | 2014-06-23 |
1174936017 | Kim Hagans | Case Manager/Care Coordinator | 2413 2nd St, Eureka, CA 95501-0811 | 2014-06-09 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538795919 | Eric Meyer Goldsmith | Physical Therapist | 2306 Dean Street, Eureka, CA 95501 | 2020-03-18 |
1609406404 | Humboldt County Behavioral Health | Community/Behavioral Health | 638 W Clark St., Bldg. E, Eureka, CA 95501 | 2020-01-21 |
1740831767 | Jacqueline Renee Coghill | Nurse Practitioner | Waterfront Recovery Services, 2413 2nd St, Eureka, CA 95501 | 2019-09-20 |
1982177275 | Jenny Bugnacki | Case Manager/Care Coordinator | 721 Wood St, Eureka, CA 95501 | 2019-01-09 |
1073023107 | Humboldt Recovery Center Inc. | Substance Abuse Rehabilitation Facility | 1303 11th St, Eureka, CA 95501 | 2017-10-03 |
1730698283 | Gabriel Holtski | Naturopath | 1632 Broadway, Suite #252, Eureka, CA 95501 | 2017-09-27 |
1164951851 | Redwood Community Services, Inc. | Foster Care Agency | 2426 6th St, Eureka, CA 95501 | 2017-06-07 |
1033651922 | Narum Clinical Services | Social Worker | 930 3rd St, Suite 201, Eureka, CA 95501 | 2016-11-09 |
1750839510 | Sierra Marie Evers-hellmich | Physical Medicine & Rehabilitation | 2103 Myrtle Avenue, Eureka, CA 95501 | 2016-09-21 |
1558720623 | Jennifer Vu | Behavioral Analyst | 730 7th St Ste A, Eureka, CA 95501 | 2016-02-18 |
Find all providers in zip 95501 |
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 |
---|---|---|---|---|
1073023107 | Humboldt Recovery Center Inc. | Substance Abuse Rehabilitation Facility | 1303 11th St, Eureka, CA 95501 | 2017-10-03 |
1235689290 | Adcs Women's Residential | Substance Abuse Rehabilitation Facility | 1742 J St, Eureka, CA 95501-2648 | 2016-10-13 |
1467739003 | Alcohol Drug Care Services,inc. | Substance Abuse Rehabilitation Facility | 528 5th St, Eureka, CA 95501-1033 | 2011-11-10 |
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 |
Please comment or provide details below to improve the information on WATERFRONT RECOVERY SERVICES.
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.