Provider Demographics
NPI:1013627041
Name:RECOVERY IS A BEACH, LLC
Entity type:Organization
Organization Name:RECOVERY IS A BEACH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:K
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:805-415-2441
Mailing Address - Street 1:44 DUVALI DR
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2151
Mailing Address - Country:US
Mailing Address - Phone:805-586-3472
Mailing Address - Fax:
Practice Address - Street 1:1317 DEL NORTE RD STE 200
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-8368
Practice Address - Country:US
Practice Address - Phone:805-586-3472
Practice Address - Fax:805-477-5639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-30
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty