=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811868219
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STELLA SOLIDARITY RECOVERY SERVICES INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/17/2025
-----------------------------------------------------
Last Update Date | 09/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 733 INGLEWOOD DR
-----------------------------------------------------
City | WEST SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95605-2108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-749-3368
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 125 CIRCUIT DR
-----------------------------------------------------
City | ROSEVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95678-2217
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-749-3368
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/MANAGING DIRECTOR
-----------------------------------------------------
Name | ROBERT JAMES STELLA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 916-749-3368
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 324500000X
-----------------------------------------------------
Taxonomy Name | Substance Abuse Rehabilitation Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------