California Familiy Institute Melrose

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

538463 Issued in CA

Legal business name

CALIFORNIA FAMILIY INSTITUTE MELROSE

Practice address

6708 Melrose Ave
Los Angeles, CA 90038-3412

Phone

(818) 601-5878

NPI assigned

Dec 18, 2014

Last updated

Dec 18, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kirsten Wallace

Title

Ceo

Phone

(818) 651-4594

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Britton Derby, MFTI

  • Substance Abuse Rehabilitation Facility
  • Los Angeles, CA
  • NPI 1730545807
  NPD (past)

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418860800000",
    "number": "1093113383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6708 MELROSE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900383412",
            "telephone_number": "818-601-5878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6708 MELROSE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900383412",
            "telephone_number": "818-601-5878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA FAMILIY INSTITUTE MELROSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-18",
        "last_updated": "2014-12-18",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "KIRSTEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-651-4594"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "538463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.