NPIMap

Organization Active NPI

La Fuente Hollywood Treatment Center LLC

  • Substance Abuse Rehabilitation Facility
  • Los Angeles, CA
National Provider Identifier
1083101661
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
LA FUENTE HOLLYWOOD TREATMENT CENTER LLC
Practice address
1601 N Gower St # 101
Los Angeles, CA 90028-7596
Phone
(323) 464-2947
NPI assigned
Apr 18, 2018
Organization subpart
Yes
Parent organization
LA FUENTE HOLLYWOOD TREATMENT CENTER LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 18, 2018

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

Authorized official

Name
Manuel Rodriguez
Title
Ceo
Phone
(323) 464-2947

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

1601 N Gower St # 101
Los Angeles, CA 90028-7596

Mailing address

5718 Fountain Ave
Los Angeles, CA 90028-8516
Phone (323) 464-2947

Other names 1

  • La Fuente Hollywood Treatment Center Outpatient Doing business as

National Provider Directory

National Provider Directory
Tax ID family
La Fuente Hollywood Treatment Center LLC2 organizations share this tax ID, including this one
Part of
La Fuente Hollywood Treatment Center LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1601 N Gower St
#101
Los Angeles, CA 90028
Phone (323) 464-2947

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524009600000",
    "number": "1083101661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5718 FOUNTAIN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900288516",
            "telephone_number": "323-464-2947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 N GOWER ST # 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287596",
            "telephone_number": "323-464-2947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA FUENTE HOLLYWOOD TREATMENT CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LA FUENTE HOLLYWOOD TREATMENT CENTER LLC",
        "enumeration_date": "2018-04-18",
        "last_updated": "2018-04-18",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-464-2947"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Fuente Hollywood Treatment Center Outpatient",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "La Fuente Hollywood Treatment Center Outpatient",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; 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.