PROVIDENCE RECOVERY CENTERS, INC. – NPI #1114549144
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.

Health Care Provider Taxonomy Code for Substance Abuse Rehabilitation Facility

PROVIDENCE RECOVERY CENTERS, INC. is a substance abuse rehabilitation facility located in MORENO VALLEY, CA. NPPES has assigned the NPI number 1114549144 to PROVIDENCE RECOVERY CENTERS, INC. on May 13, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 324500000X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PROVIDENCE RECOVERY CENTERS, INC. below.

NPI Profile for
PROVIDENCE RECOVERY CENTERS, INC.

NPI Number
1114549144
Enumeration Date

(more than 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PROVIDENCE RECOVERY CENTERS, INC.
Primary location
11165 BONNIE VIEW AVE
MORENO VALLEY, CA 92555
Phone: (951) 221-1805 Fax: (951) 422-3384
Mailing address
28728 KALMIA AVE
MORENO VALLEY, CA 92555
Phone: (951) 221-1805 Fax: (951) 422-3384
Organization Subpart
No
Authorized Official
STACY DORSEY
EXECUTIVE DIRECTOR/COO
Phone: (951) 221-1805
Updated
Certification Date
May 13, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
324500000X
- Substance Abuse Rehabilitation Facility (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.