THE CAMP RECOVERY CENTER, LLC (NPI# 1568517050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568517050 |
| Entity Type | Organization |
| Organization Name | THE CAMP RECOVERY CENTER, LLC |
| Other Organization Name | AZURE ACRES |
| Practice Address |
2264 Green Hill Rd Sebastopol CA 95472-9034 |
| Practice Telephone | 7078233385 |
| Practice Fax Number | 7078237519 |
| Mailing Telephone | 7078233385 |
| Mailing Fax Number | 7078237519 |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-01-27 |
| Authorized Official Name | MR. CHRISTOPHER HOWARD (VICE PRESIDENT & SECRETARY) |
| Authorized Official Telephone | 6158616000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 490021AP | CA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Azure Acres | Doing Business As Name - Organization |
| Azure Acres Treatment Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700437043 | The Camp Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 3600 Glen Canyon Rd, Scotts Valley, CA 95066-4923 | 2019-09-27 |
| 1972685196 | The Camp Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 3192 Glen Canyon Rd, Scotts Valley, CA 95066-4916 | 2006-10-19 |
| 1043843899 | The Camp Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 2264 Green Hill Rd, Sebastopol, CA 95472-9034 | 2020-02-20 |
| 1215368485 | The Camp Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 3192 Glen Canyon Rd, Scotts Valley, CA 95066-4916 | 2013-12-12 |
| Street Address |
2264 GREEN HILL RD |
| City | SEBASTOPOL |
| State | CA |
| Zip Code | 95472-9034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043843899 | The Camp Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 2264 Green Hill Rd, Sebastopol, CA 95472-9034 | 2020-02-20 |
| 1558543975 | Irenne Magoulas | Social Worker | 2264 Green Hill Rd, Sebastopol, CA 95472-9034 | 2007-11-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558916791 | Mellisa Nicole Elrod | Occupational Therapist | 1935 Gravenstein Hwy, Sebastopol, CA 95472 | 2019-08-05 |
| 1457820987 | Isabel Brooke Martinez | Acupuncturist | 961 Gravenstein Hwy South, # 100, Sebastopol, CA 95472 | 2018-11-14 |
| 1275025470 | Shahbano Syeda | Specialist/Technologist | 846/848 Gravenstein Hwy South, Sebastopol, CA 95472 | 2018-06-04 |
| 1467990812 | Mathew Metzgar | Marriage & Family Therapist | 1800 N. Gravenstein Hwy, Sebastopol, CA 95472 | 2017-02-06 |
| 1760939318 | Andrea Kirk | Psychologist | 876 Gravenstein Hwy S., Suite 6, Sebastopol, CA 95472 | 2016-09-01 |
| 1548629371 | Stacy Simons | Massage Therapist | 103 Morris St Ste V, Sebastopol, CA 95472 | 2016-02-22 |
| 1619341880 | Carol Schmid | Counselor | 1800 N, Gravenstein Hwy, Sebastopol, CA 95472 | 2015-11-25 |
| 1801273727 | Aaron Martinez | Specialist/Technologist | 7441 Witter Road, Sebastopol, CA 95472 | 2015-04-29 |
| 1699167049 | Nia Kaye | Marriage & Family Therapist | 130 Petaluma Ave Ste 2c, Sebastopol, CA 95472 | 2015-02-23 |
| 1497091383 | Caitlin Marie Kirkman | Midwife | 5611 Hessel Ave, Sebastopol, CA 95472 | 2012-12-20 |
| Find all providers in zip 95472 | ||||
| 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 |
|---|---|---|---|---|
| 1043843899 | The Camp Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 2264 Green Hill Rd, Sebastopol, CA 95472-9034 | 2020-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 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 | ||||
| City | SEBASTOPOL |
| Zip Code | 95472 |
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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.