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THE CAMP RECOVERY CENTER LLC NPI 1972685196


NPI Information

NPI: 1972685196
Provider Name: THE CAMP RECOVERY CENTER, LLC

Doing Business As: CAMP RECOVERY CENTER

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

CLIA Number: 05D1097384

Address:
3192 GLEN CANYON RD
SCOTTS VALLEY, CA
ZIP 95066
Phone: (831) 438-1868
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THE CAMP RECOVERY CENTER, LLC is a substance abuse rehabilitation facility in Scotts Valley, 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. THE CAMP RECOVERY CENTER, LLC NPI is 1972685196. The provider is registered as an organization entity type.
The provider Is Doing Business As Camp Recovery Center.

The provider's business location address is:

3192 GLEN CANYON RD
SCOTTS VALLEY, CA
ZIP 95066-916
Phone: (831) 438-1868
Fax: (831) 438-5833

The provider's authorized official is Christopher Howard .
The authorized official title is Vice President & Secretary and has the following contact phone number (615) 861-6000.

The CLIA number assigned to this NPI record is 05D1097384 - other - drug rehab 30 day inpe fa with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/19/2006 and was last updated on 9/23/2019.


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
1324500000XSubstance Abuse Rehabilitation Facility440011APCALIFORNIAYes

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
1ZZZH4403ZOTHERCALIFORNIABLUE SHIELD

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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