CREST RECOVERY LLC (NPI# 1962977108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962977108 |
| Entity Type | Organization |
| Organization Name | CREST RECOVERY LLC |
| Other Organization Name | TRUVIDA RECOVERY |
| Practice Address |
26202 Buena Vista Ct Laguna Hills CA 92653-5620 |
| Mailing Address |
23726 Birtcher Dr Lake Forest CA 92630-1771 |
| Practice Telephone | 9492834679 |
| Mailing Telephone | 9492834679 |
| Enumeration Date | 2018-10-03 |
| Last Update Date | 2020-04-08 |
| Authorized Official Name | CEAIRA COFFIN (BILLING DIRECTOR) |
| Authorized Official Telephone | 8332330091 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DHCS | 300351CP | 01 |
| Other Name | Type Code |
|---|---|
| TruVida Recovery | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023658200 | Crest Recovery LLC | Substance Abuse Rehabilitation Facility | 24316 Via Madrugada, Mission Viejo, CA 92692-1910 | 2020-01-15 |
| 1316402225 | Crest Recovery LLC | Substance Abuse Rehabilitation Facility | 26886 Pueblonuevo Dr, Mission Viejo, CA 92691-4410 | 2019-02-05 |
| 1629543863 | Crest Recovery LLC | Clinic/Center | 23726 Birtcher Dr, Lake Forest, CA 92630-1771 | 2018-10-03 |
| 1124593371 | Crest Recovery LLC | Substance Abuse Rehabilitation Facility | 24731 Via San Fernando, Mission Viejo, CA 92692-2431 | 2018-10-03 |
| 1235599879 | Crest Recovery LLC | Substance Abuse Rehabilitation Facility | 29522 Via Valverde, Laguna Niguel, CA 92677-1868 | 2016-02-24 |
| Street Address |
26202 BUENA VISTA CT |
| City | LAGUNA HILLS |
| State | CA |
| Zip Code | 92653-5620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932708476 | Nikkie Veyseh | Behavior Technician | 26921 Falling Leaf Dr., Laguna Hills, CA 92653 | 2020-10-24 |
| 1609480425 | Steve Ceja | Behavior Technician | 25201 Paseo De Alicia Suite 110, Laguna Hills, CA 92653 | 2020-08-31 |
| 1467006882 | Kristina Alexa Puno Morales | Dietitian, Registered | 24552 Health Center Drive, Laguna Hills, CA 92653 | 2019-07-25 |
| 1164929626 | Shoreline Consulting Services, Inc. | Clinic/Center | 23010 Lake Forest Drive, Suite B, Laguna Hills, CA 92653 | 2018-04-11 |
| 1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
| 1831613850 | Stephani A Berg | Physical Medicine & Rehabilitation | 24422 Avenida De La Carlota Suite 190, Laguna Hills, CA 92653 | 2017-08-01 |
| 1497299945 | Stephanie Lyle | Nurse Practitioner | 24221 Calle De Louisa, Suite 400, Laguna Hills, CA 92653 | 2016-12-16 |
| 1053776278 | Meillanny Gladness | Counselor | 23151 Verdugo Dr Ste 203, Laguna Hills, CA 92653 | 2015-12-16 |
| 1912383183 | Pmdca, LLC | Clinical Medical Laboratory | 23297 S Pointe Dr Ste 100, Laguna Hills, CA 92653 | 2015-08-10 |
| 1821486630 | 4mpw, Inc. | Home Health | 23232 Peralta Drive 216, Laguan Hills, CA 92653 | 2014-12-31 |
| Find all providers in zip 92653 | ||||
| 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 |
|---|---|---|---|---|
| 1235620113 | Oroville Management LLC | Substance Abuse Rehabilitation Facility | 26126 Oroville Pl, Laguna Hills, CA 92653-6315 | 2018-05-25 |
| 1689174997 | Sobertec LLC | Substance Abuse Rehabilitation Facility | 26601 Laurel Crest Dr, Laguna Hills, CA 92653-7551 | 2018-02-14 |
| 1194233825 | Sanctuary of Transformation, LLC. | Substance Abuse Rehabilitation Facility | 25755 Maple View Dr, Laguna Hills, CA 92653-7549 | 2018-01-16 |
| 1861904716 | Hope By The Sea | Substance Abuse Rehabilitation Facility | 27675 Hidden Trail Rd, Laguna Hills, CA 92653-7820 | 2017-11-01 |
| 1629520457 | Pacific View Detox, LLC | Substance Abuse Rehabilitation Facility | 26411 Chaparral Pl, Laguna Hills, CA 92653-5760 | 2016-10-27 |
| 1134679152 | Jack Jewelinski | Substance Abuse Rehabilitation Facility | 26041 Red Corral Rd, Laguna Hills, CA 92653-6310 | 2016-10-13 |
| 1992159495 | Landmark Recovery, LLC | Substance Abuse Rehabilitation Facility | 23265 S Pointe Dr, Suite 101, Laguna Hills, CA 92653-1472 | 2016-04-20 |
| 1679945448 | Julie Gibson | Substance Abuse Rehabilitation Facility | 25352 Hillary Ln, Laguna Hills, CA 92653-5217 | 2015-10-20 |
| 1891345997 | Laguna Woods Recovery LLC | Substance Abuse Rehabilitation Facility | 26411 Chaparral Pl, Laguna Hills, CA 92653-5760 | 2019-09-19 |
| 1245701978 | Recovery Services Management LLC | Substance Abuse Rehabilitation Facility | 25352 Hillary Ln, Laguna Hills, CA 92653-5217 | 2018-12-06 |
| Find all providers in LAGUNA HILLS | ||||
| City | LAGUNA HILLS |
| Zip Code | 92653 |
Please comment or provide details below to improve the information on CREST RECOVERY LLC.
| 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.