Provider Demographics
NPI:1205417748
Name:A NEW START RECOVERY CENTER, LLC
Entity Type:Organization
Organization Name:A NEW START RECOVERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMARILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-247-6111
Mailing Address - Street 1:555 SAINT CHARLES DR STE 103
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-3988
Mailing Address - Country:US
Mailing Address - Phone:800-247-6111
Mailing Address - Fax:
Practice Address - Street 1:1325 EL MONTE DR
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91362-2123
Practice Address - Country:US
Practice Address - Phone:800-247-6111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA560059APOtherPRIVATE HEALTH INSURANCE COMPANIES