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BRYAN'S HOUSE RECOVERY HOME NPI 1275001067


NPI Information

NPI: 1275001067
Provider Name: BRYAN'S HOUSE RECOVERY HOME
Classification: Substance Abuse Rehabilitation Facility - 3245S0500X
Entity Type: Organization

Specialization: Substance Abuse Treatment, Children

Address:
2000 TRAFFIC WAY
ATASCADERO, CA
ZIP 93422
Phone: (805) 460-6621
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BRYAN'S HOUSE RECOVERY HOME is a substance abuse treatment and children substance abuse rehabilitation facility in Atascadero, CA. The provider is a facility or distinct part of a facility for children that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. BRYAN'S HOUSE RECOVERY HOME NPI is 1275001067. The provider is registered as an organization entity type.

The provider's business location address is:

2000 TRAFFIC WAY
ATASCADERO, CA
ZIP 93422-523
Phone: (805) 460-6621
Fax: (866) 306-5825

The provider's authorized official is Sandra Lee Wortley .
The authorized official title is Ceo/executive Director and has the following contact phone number (805) 674-3131.

The enumeration date for this NPI number is 11/9/2018 and was last updated on 12/7/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13245S0500XSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, ChildrenYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11093914152MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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