Healthcare Provider Details

I. General information

NPI: 1700727682
Provider Name (Legal Business Name): CONSCIENTIA RECOVERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6093 MURPHY WAY
MALIBU CA
90265-4490
US

IV. Provider business mailing address

501 S. REINO RD SUITE I PMB 383
NEWBURY PARK CA
91320-5312
US

V. Phone/Fax

Practice location:
  • Phone: 805-390-3737
  • Fax:
Mailing address:
  • Phone: 805-390-3737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. CLAYTON STASSART
Title or Position: CHIEF OPERATIONS OFFICER
Credential:
Phone: 213-265-4560