Healthcare Provider Details

I. General information

NPI: 1821977117
Provider Name (Legal Business Name): SMART RECOVERY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29995 TECHNOLOGY DR STE 101A
MURRIETA CA
92563-2633
US

IV. Provider business mailing address

29995 TECHNOLOGY DR STE 101A
MURRIETA CA
92563-2633
US

V. Phone/Fax

Practice location:
  • Phone: 951-816-1778
  • Fax:
Mailing address:
  • Phone: 951-816-1778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: LEAN SMART
Title or Position: PRESIDENT
Credential: LPCC
Phone: 951-816-2717