SOUTH LAKE TAHOE RECOVERY AND REHABILITATION, LLC
NPI 1043788359
Clinic/Center - Rehabilitation, Substance Use Disorder in South Lake Tahoe, CA

Q: What is South Lake Tahoe Recovery And Rehabilitation, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

Active since November 05, 2018

591 TAHOE KEYS BLVD STE D2, SOUTH LAKE TAHOE, CA 96150(530) 539-9029 Get Directions Write a Review

NPPES record last updated: September 20, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 20, 2022, Nov 5, 2018 (2 updates tracked since 2018).

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About South Lake Tahoe Recovery And Rehabilitation, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTH LAKE TAHOE RECOVERY AND REHABILITATION, LLC (NPI 1043788359) is a healthcare organization registered as a rehabilitation, substance use disorder in South Lake Tahoe, California and active in the NPI registry since November 2018. The organization lists Nathan Tuddenham, Chief Operating Officer, as its authorized official.

NPPES Registry Identity

NPI1043788359

Entity TypeOrganization

Primary Taxonomy261QR0405X

Legal Business NameSOUTH LAKE TAHOE RECOVERY AND REHABILITATION, LLC

Location Address591 TAHOE KEYS BLVD STE D2South Lake Tahoe, CA 96150-3359

Mailing Address262 Gaffey RdWatsonville, CA 95076-9731 · (831) 740-4629 · Fax (831) 708-2450

Phone(530) 539-9029

Organization SubpartNo

Authorized OfficialNathan TuddenhamChief Operating Officer · (831) 740-4629

Enumeration DateNovember 5, 2018

Last NPPES UpdateSeptember 20, 20222 updates tracked since enumeration

NPPES CertifiedSeptember 20, 2022

✔ NPI 1043788359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities

Taxonomy Code261QR0405X

591 TAHOE KEYS BLVD STE D2, South Lake Tahoe, CA 96150

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is South Lake Tahoe Recovery And Rehabilitation, LLC's NPI number?

The NPI number for South Lake Tahoe Recovery And Rehabilitation, LLC is 1043788359. It was assigned to this organization in the NPPES registry on November 5, 2018.

Where is South Lake Tahoe Recovery And Rehabilitation, LLC located?

South Lake Tahoe Recovery And Rehabilitation, LLC is located at 591 Tahoe Keys Blvd Ste D2, South Lake Tahoe, CA 96150. The listed phone number is (530) 539-9029.

What is South Lake Tahoe Recovery And Rehabilitation, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

When was this NPI record last updated?

The NPPES record for South Lake Tahoe Recovery And Rehabilitation, LLC was last updated on September 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.