NPIMap

Organization Active NPI

California Wellness Retreat, Inc.

  • Substance Abuse Rehabilitation Facility
  • Sunland, CA
National Provider Identifier
1063293454
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
CALIFORNIA WELLNESS RETREAT, INC.
Practice address
8131 Ellenbogen St
Sunland, CA 91040-2103
Phone
(424) 666-6000
NPI assigned
Oct 11, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Vahagn Mkrtchyan
Title
Ceo
Phone
(424) 666-6000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

8131 Ellenbogen St
Sunland, CA 91040-2103

Mailing address

8131 Ellenbogen St
Sunland, CA 91040-2103
Phone (424) 666-6000

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1063293454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8131 ELLENBOGEN ST",
            "city": "SUNLAND",
            "state": "CA",
            "postal_code": "910402103",
            "telephone_number": "424-666-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8131 ELLENBOGEN ST",
            "city": "SUNLAND",
            "state": "CA",
            "postal_code": "910402103",
            "telephone_number": "424-666-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA WELLNESS RETREAT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-11",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "MKRTCHYAN",
        "authorized_official_first_name": "VAHAGN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "424-666-6000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.