Provider Demographics
NPI:1629747142
Name:LOST DREAMS AWAKEN
Entity Type:Organization
Organization Name:LOST DREAMS AWAKEN
Other - Org Name:NEW HOPE RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBISON
Authorized Official - Suffix:
Authorized Official - Credentials:SUDCC II
Authorized Official - Phone:209-527-9797
Mailing Address - Street 1:823 E ORANGEBURG AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-4619
Mailing Address - Country:US
Mailing Address - Phone:209-527-9797
Mailing Address - Fax:209-527-9825
Practice Address - Street 1:823 E ORANGEBURG AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4619
Practice Address - Country:US
Practice Address - Phone:209-527-9797
Practice Address - Fax:209-527-9825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-08
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty