I CHOOSE LIFE ADDICTION SPECIALIST NPI 1124419379

NPI Information

  • NPI: 1124419379
  • Provider Name: I CHOOSE LIFE ADDICTION SPECIALIST
  • Classification: Clinic/Center - 261QR0405X
  • Specialization: Rehabilitation, Substance Use Disorder
  • Entity Type: Organization
  • Doing Business As: ICLASS TREATMENT CENTER
  • Address: 425 E 6TH ST
    UNIT 201
    CORONA, CA
    ZIP 92879
  • Phone: (951) 339-8443

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NPI Details

I CHOOSE LIFE ADDICTION SPECIALIST is a rehabilitation and substance use disorder clinic center in Corona, CA. I CHOOSE LIFE ADDICTION SPECIALIST NPI is 1124419379. The provider is registered as an organization entity type.
The provider Is Doing Business As Iclass Treatment Center.

The provider's business location address is:

425 E 6TH ST
UNIT 201
CORONA, CA
ZIP 92879-566
Phone: (951) 339-8443
Fax: (951) 339-8443

The provider's authorized official is Renaldo Rolando Moodie .
The authorized official title is Clinical Therapist and has the following contact phone number (951) 339-8443.

The enumeration date for this NPI number is 2/10/2015 and was last updated on 2/10/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251B00000XCase ManagementNo
2251S00000XCommunity/Behavioral HealthNo
3261Q00000XClinic/CenterNo
4261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
5261QM0850XClinic/CenterAdult Mental HealthNo
6261QM0855XClinic/CenterAdolescent and Children Mental HealthNo
7261QR0401XClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)No
8261QR0405XClinic/CenterRehabilitation, Substance Use DisorderYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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