MEDICARE: PURA VIDA RECOVERY SERVICES, LLC

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
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1932926649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PURA VIDA RECOVERY SERVICES, LLC

Provider Business Mailing Address
First Line	:	2901 CLEVELAND AVE STE 103
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95403-2788
Country	:	US
Telephone Number	:	707-879-8432
Fax Number	:	844-426-0134

Provider Business Practice Location Address
First Line	:	6701 MONTECITO BLVD
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95409-2912
Country	:	US
Telephone Number	:	707-879-8432
Fax Number	:	844-426-0134

Authorized Official
Title or Position	:	CAO
Name	:	BEN A PAHLAVAN
Credential	:
Telephone Number	:	707-879-8432

Provider Enumeration Date	:	09/24/2024
Last Update Date	:	09/24/2024

Similar Medicare Providers

1609275122 — MR. HECTOR VASQUEZ JR.
Practice Location Address:

17612 ROSA DREW LN APT 2C
IRVINE, CA
92612-2912

Practice Phone: 626-224-6818
Practice Fax:

1598287799 — MR. ROCKNE SHANNON SIEGENTHALER AMFT
Practice Location Address:

942 S SANTA FE ST
VISALIA, CA
93292-2912

Practice Phone: 559-636-4000
Practice Fax:

1659367548 — MS. REBECCA MARIE BRETON MD
Practice Location Address:

1510 CAPITOLA RD
SANTA CRUZ, CA
95062-2912

Practice Phone: 831-427-3500
Practice Fax:

1295845741 — CURTIS M FROID O.D.
Practice Location Address:

1510 CAPITOLA RD
SANTA CRUZ, CA
95062-2912

Practice Phone: 831-427-3500
Practice Fax:

1699878579 — DR. GARRY CRUMMER M.D.
Practice Location Address:

1510 CAPITOLA RD
SANTA CRUZ, CA
95062-2912

Practice Phone: 831-427-3500
Practice Fax:

1114023058 — MICHAEL A AMSTER MD
Practice Location Address:

1510 CAPITOLA RD
SANTA CRUZ, CA
95062-2912

Practice Phone: 831-427-3500
Practice Fax:

Directions to “PURA VIDA RECOVERY SERVICES, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.