417 SOUTH RIVER LLC NPI 1891571659

NPI Information

  • NPI: 1891571659
  • Provider Name: 417 SOUTH RIVER LLC
  • Classification: Substance Abuse Rehabilitation Facility - 3245S0500X
  • Specialization: Substance Abuse Treatment, Children
  • Entity Type: Organization
  • :
  • CLIA Number: 05D2309637
  • Address: 33050 ANTELOPE RD STE 201202
    MURRIETA, CA
    ZIP 92563
  • Phone: (760) 485-6563

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NPI Details

417 SOUTH RIVER LLC is a substance abuse treatment and children substance abuse rehabilitation facility in Murrieta, 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. 417 SOUTH RIVER LLC NPI is 1891571659. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

33050 ANTELOPE RD STE 201202
MURRIETA, CA
ZIP 92563-489
Phone: (760) 485-6563

The provider's authorized official is Stevie Kuhn .
The authorized official title is Owner/partner and has the following contact phone number (760) 485-6563.

The CLIA number assigned to this NPI record is 05D2309637 - other - intensive outpatient with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/6/2023 and was last updated on 5/21/2025.

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
1251S00000XCommunity/Behavioral HealthNo
2261QM0855XClinic/CenterAdolescent and Children Mental HealthNo
33245S0500XSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, ChildrenYes

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: 3/30/2025

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