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NPI Code Detail

MEDICARE: RECOVERY IS A BEACH

MEDICARE: RECOVERY IS A BEACH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number : 1013627041
Entity Type Code : Organization
Provider Name (Legal Business Name) : RECOVERY IS A BEACH
Provider Business Mailing Address
First Line : 44 DUVALI DR
Second Line :
City : VENTURA
State : CA
Zip : 93003-2151
Country : US
Telephone Number : 805-586-3472
Fax Number :
Provider Business Practice Location Address
First Line : 1317 DEL NORTE RD STE 200
Second Line :
City : CAMARILLO
State : CA
Zip : 93010-8368
Country : US
Telephone Number : 805-586-3472
Fax Number : 805-477-5639
Authorized Official
Title or Position : MANAGING MEMBER
Name : KERRY K COSTELLO
Credential : LMFT
Telephone Number : 805-415-2441
Provider Enumeration Date : 11/30/2022
Last Update Date : 01/14/2026

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Directions to “RECOVERY IS A BEACH ” Practice Location

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