SOCIAL MODEL RECOVERY SYSTEMS, INC. (NPI# 1740469113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740469113 |
| Entity Type | Organization |
| Organization Name | SOCIAL MODEL RECOVERY SYSTEMS, INC. |
| Other Organization Name | MID VALLEY OUTPATIENT |
| Practice Address |
4610 Santa Anita Ave Ste D El Monte CA 91731-1295 |
| Mailing Address |
223 E Rowland St Covina CA 91723-3147 |
| Practice Telephone | 6264533432 |
| Practice Fax Number | 6264533431 |
| Mailing Telephone | 6263323145 |
| Mailing Fax Number | 6264533431 |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2013-07-31 |
| Authorized Official Name | MR. BILL FUJIHARA (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 6263323145 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 190035AN | CA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Mid Valley Outpatient | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487105813 | Social Model Recovery Systems, Inc. | Community/Behavioral Health | 3426 Cogswell Rd, El Monte, CA 91732-2785 | 2016-10-20 |
| 1164709895 | Social Model Recovery Systems, Inc. | Substance Abuse Rehabilitation Facility | 17727 E Cypress St, Covina, CA 91722-2634 | 2011-11-09 |
| 1124306386 | Social Model Recovery Systems, Inc. | Substance Abuse Rehabilitation Facility | 453 S Indiana St, Los Angeles, CA 90063-3908 | 2011-07-21 |
| 1821126939 | Social Model Recovery Systems, Inc. | Community/Behavioral Health | 23701 E East Fork Rd, Azusa, CA 91702-1477 | 2007-03-01 |
| 1497834089 | Social Model Recovery Systems, Inc. | Community/Behavioral Health | 223 E Rowland St, Covina, CA 91723-3147 | 2006-11-03 |
| 1851389993 | Social Model Recovery Systems, Inc. | Substance Abuse Rehabilitation Facility | 155 Bimini Pl, Los Angeles, CA 90004-5902 | 2005-10-12 |
| 1922096072 | Social Model Recovery Systems, Inc. | Substance Abuse Rehabilitation Facility | 4445 Burns Ave, Los Angeles, CA 90029-2702 | 2005-10-12 |
| 1821086976 | Social Model Recovery Systems, Inc. | Substance Abuse Rehabilitation Facility | 360 S Westlake Ave, Los Angeles, CA 90057-2906 | 2005-10-12 |
| 1295004224 | Social Model Recovery Systems, Inc. | Substance Abuse Rehabilitation Facility | 4445 Burns Ave, Los Angeles, CA 90029-2702 | 2011-12-20 |
| 1407134158 | Social Model Recovery Systems, Inc. | Substance Abuse Rehabilitation Facility | 3430 Cogswell Rd, El Monte, CA 91732-2785 | 2011-07-29 |
| Street Address |
4610 SANTA ANITA AVE STE D |
| City | EL MONTE |
| State | CA |
| Zip Code | 91731-1295 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154965994 | Anahi Mora | Case Manager/Care Coordinator | 3629 Santa Anita Ave, El Monte, CA 91731 | 2019-11-05 |
| 1346882321 | Rosemary Pespisa | Technician | 10558 Emery St., El Monte, CA 91731 | 2019-10-11 |
| 1962058123 | Maria Jesusa Gabriel | Licensed Vocational Nurse | 11041 E. Valley Blvd., El Monte, CA 91731 | 2019-08-14 |
| 1346720679 | Ivan Bustamante | Counselor | 11429 Valley Boulevard, El Monte, Ca 91731, El Monte, CA 91731 | 2018-08-16 |
| 1891213229 | Abbye Williams | Counselor | 11100 Valley Blvd Suite 116, El Monte, CA 91731 | 2017-09-06 |
| 1215467279 | All Health Alliance Medical Group, Inc. | Physical Medicine & Rehabilitation | 10505 Valley Boulevard, #238, El Monte, CA 91731 | 2017-06-13 |
| 1427416486 | Mai Le | Counselor | 11041 E. Valley Blvd, El Monte, CA 91731 | 2016-02-05 |
| 1235526724 | Kristine Malana | Social Worker | 10418 E. Valley Blvd., Suite A, El Monte, CA 91731 | 2015-04-22 |
| 1376980250 | Aura Hernandez | Rehabilitation Practitioner | 9865 Baldwin Pl., El Monte, CA 91731 | 2013-05-31 |
| 1639411754 | Roxana Yaneth De Paz | Nurse's Aide | 10481 Valley Blvd., El Monte, CA 91731 | 2013-03-27 |
| Find all providers in zip 91731 | ||||
| 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 |
|---|---|---|---|---|
| 1770197386 | Social Model Recovery Systems Inc | Substance Abuse Rehabilitation Facility | 3426 Cogswell Rd, El Monte, CA 91732-2785 | 2020-09-01 |
| 1407134158 | Social Model Recovery Systems, Inc. | Substance Abuse Rehabilitation Facility | 3430 Cogswell Rd, El Monte, CA 91732-2785 | 2011-07-29 |
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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 |
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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.