Provider Demographics
NPI:1306861380
Name:PRACTICAL RECOVERY PSYCHOLOGY GROUP, INC.
Entity Type:Organization
Organization Name:PRACTICAL RECOVERY PSYCHOLOGY GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:HORVATH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-546-1100
Mailing Address - Street 1:8950 VILLA LA JOLLA DR STE A220
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1711
Mailing Address - Country:US
Mailing Address - Phone:858-546-1100
Mailing Address - Fax:858-455-0141
Practice Address - Street 1:8950 VILLA LA JOLLA DR STE A220
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1711
Practice Address - Country:US
Practice Address - Phone:858-546-1100
Practice Address - Fax:858-455-0141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACP7732103T00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP7732Medicare ID - Type UnspecifiedPSYCHOLOGIST