WELLNESS RECOVERY RETREAT CENTER NPI 1760850945

NPI Information

NPI: 1760850945
Provider Name: WELLNESS RECOVERY RETREAT CENTER

Doing Business As: WELLNESS RETREAT RECOVERY CENTER

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

Address:
25971 MAR VISTA CT
LOS GATOS, CA
ZIP 95033
Phone: (855) 762-3797
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WELLNESS RECOVERY RETREAT CENTER is a substance abuse rehabilitation facility in Los Gatos, CA. The provider is 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. WELLNESS RECOVERY RETREAT CENTER NPI is 1760850945. The provider is registered as an organization entity type.
The provider Is Doing Business As Wellness Retreat Recovery Center.

The provider's business location address is:

25971 MAR VISTA CT
LOS GATOS, CA
ZIP 95033-026
Phone: (855) 762-3797
Fax: (408) 351-4494

The provider's authorized official is Angel Garcia .
The authorized official title is Ceo and has the following contact phone number (855) 762-3797.

The CLIA number assigned to this NPI record is 05D2173054 - other - inpatient substance abuse with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/4/2015 and was last updated on 6/17/2022.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	324500000X	Substance Abuse Rehabilitation Facility				Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	430084AP	OTHER	CALIFORNIA	CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES

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

NPI Synchronization or Removal

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