APPLEGATE RECOVERY BLAKESLEE
NPI 1811648967
Family Medicine - Addiction Medicine in Blakeslee, PA

NPI Status: Active since January 11, 2022

Contact Information

393 ROUTE PA 940 #2
BLAKESLEE, PA
ZIP 18610
Phone: (214) 379-3300

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  • Organization
  • Family Medicine
  • Addiction Medicine
  • CLIA Number: 39D2167165
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 06-03-2027

About APPLEGATE RECOVERY BLAKESLEE

This page provides the complete NPI Profile along with additional information for Applegate Recovery Blakeslee, a provider established in Blakeslee, Pennsylvania operating as a Family Medicine, focusing in addiction medicine . The healthcare provider is registered in the NPI registry with number 1811648967 assigned on January 2022. The practitioner's primary taxonomy code is 207QA0401X. The provider is registered as an organization and their NPI record was last updated one year ago. Applegate Recovery Blakeslee operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Applegate Recovery Blakeslee. The authorized official of this NPI record is Bruce Jarvie (Vp, Treasurer)

NPI
1811648967
Provider Legal Name
FAMILY RECOVERY, LLC
Other Organization Name
APPLEGATE RECOVERY BLAKESLEE
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
393 ROUTE PA 940 #2 BLAKESLEE, PA 18610
Location Phone
(214) 379-3300
Mailing Address
1720 LAKEPOINTE DR STE 117 LEWISVILLE, TX 75057
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-11-2022
Last Update Date
07-29-2024
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine Addiction Medicine

Taxonomy Code
207QA0401X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A family medicine physician who specializes in the diagnosis and treatment of addictions.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

BRUCE JARVIE

Authorized Official Title
VP, TREASURER
Authorized Official Phone
(214) 379-3300

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
39D2167165
Facility Type
Physician Office
Certificate Effective Date
June 04, 2025
Certificate Expiration Date
June 03, 2027
Laboratory Director
DR. GREGORY FAMIGLIO
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Applegate Recovery Blakeslee to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1811648967
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
282112416912
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 2 + 1 + 1 + 2 + 4 + 1 + 6 + 9 + 1 + 2 + 24 = 63
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 63 = 77

The NPI number 1811648967 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1811648967, enumerated in the NPI registry as an "organization" on January 11, 2022

The provider is located at 393 Route Pa 940 #2 Blakeslee, Pa 18610 and the phone number is (214) 379-3300

This medical organization specializes in Family Medicine with taxonomy code 207QA0401X with a focus in Addiction Medicine

The provider's CLIA number is 39D2167165 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on January 11, 2022. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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