CALIFORNIA COASTAL RECOVERY CENTERS (NPI# 1609303924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609303924 |
| Entity Type | Organization |
| Organization Name | CALIFORNIA COASTAL RECOVERY CENTERS |
| Other Organization Name | IMMERSIVE RECOVERY |
| Practice Address |
1582 W San Marcos Blvd Ste 301 San Marcos CA 92078-4081 |
| Practice Telephone | (858) 880-4516 |
| Mailing Telephone | 8588804516 |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2017-05-17 |
| Authorized Official Name | MR. WESLEY HEIM (PROGRAM ADMINISTRATOR) |
| Authorized Official Telephone | 8583429151 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 370169AP | CA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Immersive Recovery | Doing Business As Name - Organization |
| Street Address |
1582 W SAN MARCOS BLVD STE 301 |
| City | SAN MARCOS |
| State | CA |
| Zip Code | 92078-4081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427392182 | Brandi Danae Ducote | Marriage & Family Therapist | 1582 W San Marcos Blvd Ste 301, San Marcos, CA 92078-4081 | 2012-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437623253 | Tania Borja-rodriguez | Nurse Practitioner | 334 Via Vera Cruz #257, San Marcos, CA 92078 | 2019-01-15 |
| 1558846824 | Mckenzie Daile Sorensen | Dentist | 145 S Las Posas Rd Ste 162, San Marcos, CA 92078 | 2018-10-02 |
| 1548750169 | West2north Medical Solutions Inc | Physical Medicine & Rehabilitation | 1595 Grand Ave Ste 100, San Marcos, CA 92078 | 2018-05-18 |
| 1700385747 | Wytoshery Monea Williams | Nurse Practitioner | 1912 Northstar Way, 130, San Marcos, CA 92078 | 2018-02-05 |
| 1457878415 | Smile Community Clinic Inc | Dentist | 670 W. San Marcos Blvd. Ste 103-b, San Marcos, CA 92078 | 2017-08-29 |
| 1740636232 | Ethelaine Centeno | Occupational Therapist | 1615 S. Rancho Santa Fe Road, San Marcos, CA 92078 | 2016-05-13 |
| 1336506203 | Nga Thien Ta | Pharmacist | 671 Rancho Santa Fe, San Marcos, CA 92078 | 2016-01-24 |
| 1689039349 | Kayleigh Ann Desrosiers | Physical Therapist | 137 S Las Posas Rd Ste 254, San Marcos, CA 92078 | 2015-12-23 |
| 1821475930 | Anna Yu | Social Worker | 310 S. Twin Oaks Valley Rd., #107-381, San Marcos, CA 92078 | 2015-04-28 |
| 1831582592 | Bewell Home Physical Therapy P C | Clinic/Center | 1582 W San Marcos Blvd Ste 105b, San Marcos, CA 92078 | 2015-03-05 |
| Find all providers in zip 92078 | ||||
| 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 |
|---|---|---|---|---|
| 1801496302 | Sunrise Rehab and Recovery, LLC | Substance Abuse Rehabilitation Facility | 1106 N Interstate 35, San Marcos, TX 78666-7030 | 2020-10-26 |
| 1285013672 | Present Moments Recovery | Substance Abuse Rehabilitation Facility | 1809 Windriver St, San Marcos, CA 92078-1094 | 2015-05-19 |
| 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 | ||||
| City | SAN MARCOS |
| Zip Code | 92078 |
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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.