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SAN DIEGO FREEDOM RANCH, INC.
NPI 1093937591
Substance Abuse Rehabilitation Facility in Campo, CA

Active since May 03, 2007CLIA 05D2324530 · Waiver
1777 BUCKMAN SPRINGS RD, CAMPO, CA 91906(619) 478-5696(619) 478-2404 Get Directions Write a Review

NPPES record last updated: August 31, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 31, 2020, Jul 23, 2018 (2 updates tracked since 2018).

About San Diego Freedom Ranch, Inc. NPPES

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

SAN DIEGO FREEDOM RANCH, INC. (NPI 1093937591) is a healthcare organization registered as a substance abuse rehabilitation facility in Campo, California and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through May 26, 2027 and lists Michael Lee Huffaker, Operations Manager, as its authorized official.

NPPES Registry Identity

NPI1093937591
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameSAN DIEGO FREEDOM RANCH, INC.
Location Address1777 BUCKMAN SPRINGS RDCampo, CA 91906
Mailing AddressPo Box 157Campo, CA 91906 · (619) 478-5696 · Fax (619) 478-2404
Phone(619) 478-5696
Fax(619) 478-2404
Organization SubpartNo
Authorized OfficialMichael Lee HuffakerOperations Manager · (619) 478-5696
Enumeration DateMay 3, 2007
Last NPPES UpdateAugust 31, 20202 updates tracked since enumeration
NPPES CertifiedAugust 31, 2020
✔ NPI 1093937591 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
License✔ Licensed in CA · 370004AN
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
1777 BUCKMAN SPRINGS RD, Campo, CA 91906
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2324530

San Diego Freedom Ranch, Inc · Campo, CA
Active · expires May 26, 2027
CLIA Number05D2324530
Laboratory TypeDrug&alcohol Treatment Cn
Certificate Effective DateMay 27, 2025
Certificate Expiration DateMay 26, 2027
Laboratory DirectorChristian Small
Laboratory Phone(619) 478-5696
Laboratory LocationSan Diego Freedom Ranch, Inc1777 Buckman Springs Rd, Campo, CA 91906
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OMAR HERNANDEZ RADT
Counselor (Addiction (Substance Use Disorder))
1777 BUCKMAN SPRINGS RD
CAMPO, CA 91906
San Diego County (619) 478-5696
JONATHAN SANDOVAL CCMA
Physician Assistant
1777 BUCKMAN SPRINGS RD
CAMPO, CA 91906
San Diego County (619) 478-5696
MR. MARCO MARTINEZ RADT
Counselor (Addiction (Substance Use Disorder))
1777 BUCKMAN SPRINGS RD
CAMPO, CA 91906
San Diego County (619) 478-5696
CORINNA D. BYNUM RN
Registered Nurse (Administrator)
1777 BUCKMAN SPRINGS RD
CAMPO, CA 91906
San Diego County (619) 478-5696
TIM SHAPLIN RADT
Counselor (Addiction (Substance Use Disorder))
1777 BUCKMAN SPRINGS RD
CAMPO, CA 91906
San Diego County (619) 478-5696
CARLOS ALBERTO RAMIREZ RADT
Counselor (Addiction (Substance Use Disorder))
1777 BUCKMAN SPRINGS RD
CAMPO, CA 91906
San Diego County (619) 478-5696
CHRISTOPHER DAVID SERNA CPSS
Counselor (Addiction (Substance Use Disorder))
1777 BUCKMAN SPRINGS RD
CAMPO, CA 91906
San Diego County (619) 478-5696
CHANTAL CAMARENA RADT
Counselor (Addiction (Substance Use Disorder))
1777 BUCKMAN SPRINGS RD
CAMPO, CA 91906
San Diego County (619) 478-5696

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 San Diego Freedom Ranch, Inc.'s NPI number?

The NPI number for San Diego Freedom Ranch, Inc. is 1093937591. It was assigned to this organization in the NPPES registry on May 3, 2007.

Where is San Diego Freedom Ranch, Inc. located?

San Diego Freedom Ranch, Inc. is located at 1777 Buckman Springs Rd, Campo, CA 91906. The listed phone number is (619) 478-5696.

What is San Diego Freedom Ranch, Inc.'s specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does San Diego Freedom Ranch, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2324530) is associated with this NPI, valid through May 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for San Diego Freedom Ranch, Inc. was last updated on August 31, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.