PACIFIC PALMS RECOVERY, LLC. (NPI# 1679992853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679992853 |
| Entity Type | Organization |
| Organization Name | PACIFIC PALMS RECOVERY, LLC. |
| Practice Address |
3551 Camino Mira Costa Ste T San Clemente CA 92672-3504 |
| Practice Telephone | 9499435188 |
| Practice Fax Number | 9495428565 |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2014-04-15 |
| Authorized Official Name | AMY CHRISTLE (VP/CEO) |
| Authorized Official Telephone | 9499435188 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 300273AP | CA | Residential Treatment Facilities |
| Street Address |
3551 CAMINO MIRA COSTA STE T |
| City | SAN CLEMENTE |
| State | CA |
| Zip Code | 92672-3504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598007429 | Nubia Tellis | Marriage & Family Therapist | 3551 Camino Mira Costa Ste T, San Clemente, CA 92672-3508 | 2013-03-18 |
| 1124675822 | Jennifer Alejandra Radilla Quijas | Social Worker | 3551 Camino Mira Costa Ste T, San Clemente, CA 92672-3504 | 2019-08-19 |
| 1487019584 | Samar Papaie | Social Worker | 3551 Camino Mira Costa Ste T, San Clemente, CA 92672 | 2015-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355234 | Julie Case | Massage Therapist | 205 Via Presa, I Do Not Work From Home- I Am A Contractor, San Clemente, CA 92672 | 2020-10-30 |
| 1396213971 | Kirtney So Lim | Military Health Care Provider | 62 Area San Mateo Naval Clinic, Camp Pendleton, CA 92672 | 2018-11-13 |
| 1407322258 | Lodie Ikeda | Non-emergency Medical Transport (VAN) | 119 Avenida Dolores B, San Clemente, CA 92672 | 2018-10-19 |
| 1629566245 | I-ting Wang | Counselor | 3551 Camino Mira Costa San Clemente, Suite T, San Clemente, CA 92672 | 2018-04-30 |
| 1174046874 | Russell Thompson Chiropractic Inc | Clinic/Center | 629 Camino De Los Mares, Ste. 104, San Clemente, CA 92672 | 2017-07-25 |
| 1518320415 | Addiction Health Alliance LLC | Clinical Medical Laboratory | 605 Avenida Las Flores, San Clemente, CA 92672 | 2016-03-30 |
| 1871961342 | Paul Van Zeumeren | Marriage & Family Therapist | 2715 Calle Del Comercio, Unit C, San Clemente, CA 92672 | 2015-09-14 |
| 1194043596 | Sima Moayed | Pharmacist | 801 N. Elcamino Real, San Clemente, CA 92672 | 2010-05-10 |
| 1942539432 | Martha Elena Hall | Acupuncturist | 131 W. El Portal, San Clemente, CA 92672 | 2009-12-14 |
| 1922334515 | Katie B Mann | Social Worker | 1401 N. El Camino Real, #100, San Clemente, CA 92672 | 2009-11-02 |
| Find all providers in zip 92672 | ||||
| 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 |
|---|---|---|---|---|
| 1366003378 | New Method Wellness, Inc. | Substance Abuse Rehabilitation Facility | 313 Calle Villario, San Clemente, CA 92672-2212 | 2019-06-21 |
| 1447767330 | Sobertec LLC | Substance Abuse Rehabilitation Facility | 402 Pasadena Ct, San Clemente, CA 92672-5477 | 2018-01-02 |
| 1750898763 | Sobertec LLC | Substance Abuse Rehabilitation Facility | 4425 Mar Escarpa, San Clemente, CA 92673-6412 | 2017-12-29 |
| 1871941583 | Socal Detox, LLC | Substance Abuse Rehabilitation Facility | 835 Avenida Salvador, San Clemente, CA 92672-2322 | 2016-06-03 |
| 1912355850 | The House of The Rising Son | Substance Abuse Rehabilitation Facility | 521 W Avenida De Los Lobos Marinos, San Clemente, CA 92672-4374 | 2016-06-01 |
| 1093185753 | Luminance Health Group, Inc. | Substance Abuse Rehabilitation Facility | 1804 Via Sage, San Clemente, CA 92673-3710 | 2015-10-06 |
| 1851760938 | Kool Living Inc. | Substance Abuse Rehabilitation Facility | 449 Avenida Crespi, San Clemente, CA 92672-3331 | 2015-09-18 |
| 1528446044 | Pain Recovery Medical Group | Substance Abuse Rehabilitation Facility | 243 Avenida La Cuesta, San Clemente, CA 92672-2140 | 2015-05-16 |
| 1881072304 | Kool Living, Inc. | Substance Abuse Rehabilitation Facility | 4014 Calle Bienvenidos, San Clemente, CA 92672-2610 | 2015-05-16 |
| 1932504024 | Sobertec LLC | Substance Abuse Rehabilitation Facility | 610 Avenida Acapulco, San Clemente, CA 92672-2461 | 2014-10-31 |
| Find all providers in SAN CLEMENTE | ||||
| City | SAN CLEMENTE |
| Zip Code | 92672 |
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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.