PHOENIX RISING RECOVERY
NPI 1942702055
Clinic/Center - Rehabilitation, Substance Use Disorder in Palm Desert, CA
NPI Status: Active since March 05, 2018
Contact Information
77725 ENFIELD LN # 100-200
PALM DESERT, CA
ZIP 92211
Phone: (760) 345-7239
- Organization
- Clinic/Center
- Rehabilitation, Substance Use Disorder
- CLIA Number: 05D2129742
- CLIA Cert. Type: Other - DRUG ALCOHOL TREATMENT
- CLIA Exp. Date: 04-24-2027
About PHOENIX RISING RECOVERY
This page provides the complete NPI Profile along with additional information for Phoenix Rising Recovery, a provider established in Palm Desert, California operating as a Clinic/center, focusing in rehabilitation, substance use disorder . The healthcare provider is registered in the NPI registry with number 1942702055 assigned on March 2018. The practitioner's primary taxonomy code is 261QR0405X with license number 330143BP (CA). The provider is registered as an organization and their NPI record was last updated 8 years ago. The provider's is doing business as Phoenix Rising Recovery. The authorized official of this NPI record is Amy Crichton (Executive Director)
- NPI
- 1942702055
- Provider Legal Name
- EXECUTIVE RECOVERY GROUP, INC
- Other Organization Name
- PHOENIX RISING RECOVERY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 77725 ENFIELD LN # 100-200 PALM DESERT, CA 92211
- Location Phone
- (760) 345-7239
- Mailing Address
- 77725 ENFIELD LN PALM DESERT, CA 92211
- Mailing Phone
- (760) 409-1287
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 03-05-2018
- Last Update Date
- 08-07-2018
- Code Navigator
Location Map
Secondary Locations
- 17801 Twilight Ln
Encino, CA 91316
(760) 409-1287 - 35450 Pegasus Ct
Palm Desert, CA 92211
(760) 409-1287
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Rehabilitation, Substance Use Disorder
- Taxonomy Code
- 261QR0405X
- Type
- Ambulatory Health Care Facilities
- License No.
- 330143BP
- License State
- CA
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | 330143BP (CA) |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D2129742
- Facility Type
- Other - DRUG ALCOHOL TREATMENT
- Certificate Effective Date
- April 25, 2025
- Certificate Expiration Date
- April 24, 2027
- Laboratory Director
- MARK H. BOUFFARD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Phoenix Rising Recovery to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for PHOENIX RISING RECOVERY
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1942702055, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 55 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1942702055, enumerated as an "organization" on March 05, 2018.
The provider is located at 77725 ENFIELD LN # 100-200 PALM DESERT, CA 92211 and the phone number is (760) 345-7239.
Clinic/Center with taxonomy code 261QR0405X and a focus in Rehabilitation, Substance Use Disorder.
