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CHRONICLES OF SUCCESS RECOVERY SERVICES LLC
NPI 1629801543
Clinic/Center - Mental Health (Including Community Mental Health Center) in Medford, OR

Active since August 26, 2024
3140 JUANIPERO WAY STE 101, MEDFORD, OR 97504(541) 508-0336(541) 508-0330 Get Directions Write a Review

NPPES record last updated: June 3, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 3, 2025, Mar 31, 2025 (2 updates tracked since 2025).

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 1629801543) is a healthcare organization registered as a mental health (including community mental health center) in Medford, Oregon and active in the NPI registry since August 2024. The organization lists Donique Boazeman, Owner/administrator, as its authorized official.

NPPES Registry Identity

NPI1629801543
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameCHRONICLES OF SUCCESS RECOVERY SERVICES LLC
Location Address3140 JUANIPERO WAY STE 101Medford, OR 97504-8647
Mailing Address5441 S Macadam Ave Ste NPortland, OR 97239-6106 · (866) 674-3347
Phone(541) 508-0336
Fax(541) 508-0330
Organization SubpartNo
Authorized OfficialDonique BoazemanOwner/administrator · (313) 977-2767
Enumeration DateAugust 26, 2024
Last NPPES UpdateJune 3, 20252 updates tracked since enumeration
NPPES CertifiedJune 3, 2025
✔ NPI 1629801543 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
Also ListedMealsTaxonomy 174200000X
Also ListedLodgingTaxonomy 177F00000X
Also ListedCase ManagementTaxonomy 251B00000X
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X
3140 JUANIPERO WAY STE 101, Medford, OR 97504
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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
CHRONICLES OF SUCCESS RECOVERY SERVICES LLC
Counselor (Addiction (Substance Use Disorder))
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
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 1629801543. It was assigned to this organization in the NPPES registry on August 26, 2024.

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) 508-0336.

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

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

When was this NPI record last updated?

The NPPES record for Chronicles Of Success Recovery Services LLC was last updated on June 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.