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ALTA MIRA RECOVERY PROGRAMS
NPI 1669764908
Substance Abuse Rehabilitation Facility in Sausalito, CA

Active since May 04, 2011CLIA 05D2051870 · Waiver
125 BULKLEY AVE, SAUSALITO, CA 94965(415) 332-1350 Get Directions Write a Review

NPPES record last updated: May 24, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Alta Mira Recovery Programs NPPES

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

ALTA MIRA RECOVERY PROGRAMS (NPI 1669764908) is a healthcare organization registered as a substance abuse rehabilitation facility in Sausalito, California and active in the NPI registry since May 2011. The organization holds a CLIA Waiver certificate valid through September 28, 2026 and lists Wesley Stephenson, Vice President Of Finance, as its authorized official.

NPPES Registry Identity

NPI1669764908
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameALTA MIRA RECOVERY PROGRAMS
Location Address125 BULKLEY AVESausalito, CA 94965-2231
Mailing Address7918 El Cajon Blvd, Ste N227La Mesa, CA 91942 · (415) 332-1350
Phone(415) 332-1350
Organization SubpartNo
Authorized OfficialWesley StephensonVice President Of Finance · (619) 820-0034
Enumeration DateMay 4, 2011
Last NPPES UpdateMay 24, 2023
NPPES CertifiedMay 24, 2023
✔ NPI 1669764908 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
License✔ Licensed in CA · 210034CP
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.
Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X
125 BULKLEY AVE, Sausalito, CA 94965
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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 05D2051870

Alta Mira Recovery Programs · Sausalito, CA
Active · expires Sep 28, 2026
CLIA Number05D2051870
Laboratory TypeResidential Treatment Ctr
Certificate Effective DateSeptember 29, 2024
Certificate Expiration DateSeptember 28, 2026
Laboratory DirectorMark J. Schiller
Laboratory Phone(415) 432-2529
Laboratory LocationAlta Mira Recovery Programs125 Bulkley Ave, Sausalito, CA 94965
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

DR. LAURA ELIZABETH NATTA PH.D.
Clinical Neuropsychologist
125 BULKLEY AVE
SAUSALITO, CA 94965
Marin County (415) 339-6088
ALTA MIRA TREATMENT CENTERS
Substance Abuse Rehabilitation Facility
125 BULKLEY AVE
SAUSALITO, CA 94965
Marin County (954) 587-7771

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 Alta Mira Recovery Programs's NPI number?

The NPI number for Alta Mira Recovery Programs is 1669764908. It was assigned to this organization in the NPPES registry on May 4, 2011.

Where is Alta Mira Recovery Programs located?

Alta Mira Recovery Programs is located at 125 Bulkley Ave, Sausalito, CA 94965. The listed phone number is (415) 332-1350.

What is Alta Mira Recovery Programs's specialty?

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

Does Alta Mira Recovery Programs hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2051870) is associated with this NPI, valid through September 28, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Alta Mira Recovery Programs was last updated on May 24, 2023. 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.