Provider Demographics
NPI:1902134729
Name:OPRIMUM DYNAMIC ACHIEVEMENT
Entity Type:Organization
Organization Name:OPRIMUM DYNAMIC ACHIEVEMENT
Other - Org Name:ADDICTION RECOVERY CENTER OF TEMECULA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARIN
Authorized Official - Middle Name:D'ANN
Authorized Official - Last Name:SARFATY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-699-3030
Mailing Address - Street 1:28364 VINCENT MORAGA
Mailing Address - Street 2:SUITE C
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590
Mailing Address - Country:US
Mailing Address - Phone:951-699-3030
Mailing Address - Fax:
Practice Address - Street 1:28364 VINCENT MORAGA
Practice Address - Street 2:SUITE C
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590
Practice Address - Country:US
Practice Address - Phone:951-699-3030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty