Provider Demographics
| NPI: | 1780776708 |
|---|---|
| Name: | BAY RECOVERY CENTERS, INC. |
| Entity type: | Organization |
| Organization Name: | BAY RECOVERY CENTERS, INC. |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | ANTHONY |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | HILL |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | PHD |
| Authorized Official - Phone: | 858-490-3460 |
| Mailing Address - Street 1: | 4241 JUTLAND DR |
| Mailing Address - Street 2: | SUITE 103 |
| Mailing Address - City: | SAN DIEGO |
| Mailing Address - State: | CA |
| Mailing Address - Zip Code: | 92117-3663 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 858-490-3460 |
| Mailing Address - Fax: | 858-490-3462 |
| Practice Address - Street 1: | 2206 BALBOA AVE |
| Practice Address - Street 2: | |
| Practice Address - City: | SAN DIEGO |
| Practice Address - State: | CA |
| Practice Address - Zip Code: | 92109-4735 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 858-274-6633 |
| Practice Address - Fax: | 858-274-6643 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-09-28 |
| Last Update Date: | 2025-09-11 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| 103T00000X, 106H00000X, 163W00000X, 374U00000X, 261QI0500X, 261QP3300X, 261QR0405X, 261QM0850X, 261QP2000X, 261QP2300X, 101Y00000X, 101YA0400X, 101YM0800X, 104100000X | ||
| CA | 261Q00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
| No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
| No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty | |
| No | 163W00000X | Nursing Service Providers | Registered Nurse | Group - Multi-Specialty | |
| No | 374U00000X | Nursing Service Related Providers | Home Health Aide | Group - Multi-Specialty | |
| No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | Group - Multi-Specialty | |
| No | 261QI0500X | Ambulatory Health Care Facilities | Clinic/Center | Infusion Therapy | Group - Multi-Specialty |
| No | 261QP3300X | Ambulatory Health Care Facilities | Clinic/Center | Pain | Group - Multi-Specialty |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | |
| No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | |
| No | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | |
| No | 261QP2300X | Ambulatory Health Care Facilities | Clinic/Center | Primary Care | |
| No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
| No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| CA | ========= | Other | EIN |
