PROVIDENCE RECOVERY CENTERS, INC. (NPI# 1457891699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457891699 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE RECOVERY CENTERS, INC. |
| Practice Address |
23703 Piedras Rd Perris CA 92570-7263 |
| Practice Telephone | 9514431715 |
| Practice Fax Number | 9519405384 |
| Mailing Telephone | 9514431715 |
| Mailing Fax Number | 9519405384 |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2017-03-07 |
| Authorized Official Name | MS. CYNDY SMITH (DRUG AND ALCOHOL COUNSELOR) |
| Authorized Official Telephone | 9514431715 |
| Authorized Official Credential | CAS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | CA | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114549144 | Providence Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 11165 Bonnie View Ave, Moreno Valley, CA 92555 | 2020-05-13 |
| Street Address |
23703 PIEDRAS RD |
| City | PERRIS |
| State | CA |
| Zip Code | 92570-7263 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659861185 | Derriea Mcglothern | Specialist/Technologist | 23126 Rider St, Perris, CA 92570 | 2018-05-10 |
| 1790235109 | Jeromy Ford | Counselor | 226 W. 4th St, Perris, CA 92570 | 2016-10-10 |
| 1699196485 | Taniya Sweeney | Community/Behavioral Health | 413 South B Strret, Perris, CA 92570 | 2013-12-20 |
| 1790091718 | Josh B Neal | Counselor | 827 Georgiana Ct, Perris, CA 92570 | 2010-08-27 |
| 1427370915 | Riverside Recovery Resources | Clinic/Center | 13911 Perris Blvd, Perris, CA 92570 | 2010-02-24 |
| 1144471939 | Three Angels Medical Professional Corporation | Internal Medicine | 180 East 4th St, Suite B and C, Perris, CA 92570 | 2008-10-10 |
| 1205091790 | Jill None Demos | Counselor | 24050 Christmas Tree Lane, Perris, CA 92570 | 2008-07-23 |
| 1598929341 | Jacqueline Anne Rockwell | Counselor | 555 Perris Blvd, Peris, CA 92570 | 2008-07-10 |
| 1053584128 | Perris Union High School District | Local Education Agency (LEA) | 755-b North A Street, Perris, CA 92570 | 2008-04-09 |
| 1477735215 | Christianne Nelson | Case Management | 308 E San Jacinto Avenue, Perris, CA 92570 | 2007-12-04 |
| Find all providers in zip 92570 | ||||
| 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 |
|---|---|---|---|---|
| 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.