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CHRONICLES OF SUCCESS RECOVERY SERVICES LLC
NPI 1104765825
Counselor - Addiction (Substance Use Disorder) in Medford, OR

Active since March 27, 2026
3140 JUANIPERO WAY STE 101, MEDFORD, OR 97504(541) 323-4800(541) 508-0330 Get Directions Write a Review

NPPES record last updated: May 18, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 18, 2026, Mar 27, 2026 (2 updates tracked since 2026).

About Chronicles Of Success Recovery Services Llc NPPES

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

CHRONICLES OF SUCCESS RECOVERY SERVICES LLC (NPI 1104765825) is a healthcare organization registered as an addiction (substance use disorder) in Medford, Oregon and active in the NPI registry since March 2026. The organization lists Donique Boazeman, Owner/administrator, as its authorized official.

NPPES Registry Identity

NPI1104765825
Entity TypeOrganization
Primary Taxonomy101YA0400X
Legal Business NameCHRONICLES OF SUCCESS RECOVERY SERVICES LLC
Location Address3140 JUANIPERO WAY STE 101Medford, OR 97504-8647
Mailing Address3140 Juanipero Way Ste 101Medford, OR 97504-8647 · (541) 323-4800 · Fax (541) 508-0330
Phone(541) 323-4800
Fax(541) 508-0330
Organization SubpartNo
Authorized OfficialDonique BoazemanOwner/administrator · (313) 977-2767
Enumeration DateMarch 27, 2026
Last NPPES UpdateMay 18, 20262 updates tracked since enumeration
NPPES CertifiedMay 18, 2026
✔ NPI 1104765825 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
3140 JUANIPERO WAY STE 101, Medford, OR 97504
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 8

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

CHLOE BURTZ
Community Health Worker
3140 JUANIPERO WAY STE 101
MEDFORD, OR 97504
Jackson County (541) 323-4800
DIONTE DAVIS
Health and Wellness Coach
3140 JUANIPERO WAY STE 101
MEDFORD, OR 97504
Jackson County (541) 323-4800
MRS. JULIE MARIE BOWNE LMT
Massage Therapist
3140 JUANIPERO WAY STE 101
MEDFORD, OR 97504
Jackson County (541) 690-1083
MARLON DAVIS
Community Health Worker
3140 JUANIPERO WAY STE 101
MEDFORD, OR 97504
Jackson County (541) 323-4800
MASON HOWELL
Community Health Worker
3140 JUANIPERO WAY STE 101
MEDFORD, OR 97504
Jackson County (541) 323-4800
DONIQUE BOAZEMAN
Case Manager/Care Coordinator
3140 JUANIPERO WAY STE 101
MEDFORD, OR 97504
Jackson County (541) 323-4800
CHRONICLES OF SUCCESS RECOVERY SERVICES LLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
3140 JUANIPERO WAY STE 101
MEDFORD, OR 97504
Jackson County (541) 508-0336
AYO A GLANTON
Case Manager/Care Coordinator
3140 JUANIPERO WAY STE 101
MEDFORD, OR 97504
Jackson County (541) 323-4800

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 Chronicles Of Success Recovery Services LLC's NPI number?

The NPI number for Chronicles Of Success Recovery Services LLC is 1104765825. It was assigned to this organization in the NPPES registry on March 27, 2026.

Where is Chronicles Of Success Recovery Services LLC located?

Chronicles Of Success Recovery Services LLC is located at 3140 Juanipero Way Ste 101, Medford, OR 97504. The listed phone number is (541) 323-4800.

What is Chronicles Of Success Recovery Services LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Chronicles Of Success Recovery Services LLC was last updated on May 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.