Oregon Street Recovery Center

LBN: Legacy Village, Llc
Oregon Street Recovery Center is an health care organization with primary practice located at 230 Hans Pl , Nipomo CA 93444-5025. The organization recently has 2 registered licenses in different health care specialties including Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, Residential Treatment Facilities / Substance Abuse Rehabilitation Facility. Residential Treatment Facilities / Substance Abuse Rehabilitation Facility is the primary health care specialty. Legacy Village, Llc can be contacted via phone (805) 792-3595, or through Farmer, Dennis Scott via phone (805) 792-3595.

Contact Information

Primary practice address
230 Hans Pl Nipomo CA 93444-5025
Phone: (805) 792-3595
Fax: (661) 489-0573
Website:
Map and Directions
Authorized official contact:
Name: Farmer, Dennis Scott
Phone: (805) 792-3595

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X California

Profile Details

NPI number 1295185841
LBN Legal business name Legacy Village, Llc
DBA Doing business as Oregon Street Recovery Center
Authorized official Farmer, Dennis Scott
Entity Organization
Organization subpart 1 No
Enumeration date Jun 14th, 2016
Last updated Apr 13th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295185841 NPPES
California Other 150071AP RESIDENTIAL TREATMENT LICENSE

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