NPIMap

Organization Active NPI

Mindful Growth Foundation

  • Mental Illness Community Based Residential Treatment Facility
  • Los Angeles, CA
National Provider Identifier
1114491636
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
MINDFUL GROWTH FOUNDATION
Practice address
3924 W Adams Blvd
Los Angeles, CA 90018-1755
Phone
(239) 980-6543
Fax
(323) 967-7746
NPI assigned
Jan 17, 2019
Organization subpart
Yes
Parent organization
MINDFUL GROWTH FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Authorized official

Name
Jasmine M Sampson, MSW/MPHNPI 1831662527
Title
Ceo
Phone
(323) 590-9813

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

3924 W Adams Blvd
Los Angeles, CA 90018-1755

Mailing address

3924 W Adams Blvd
Los Angeles, CA 90018-1755
Phone (323) 998-0654

Other names 1

  • MINDFUL GROWTH FOUNDATION #1 Other name

National Provider Directory

National Provider Directory
Tax ID family
Mindful Growth Foundation8 organizations share this tax ID, including this one
Part of
Mindful Growth Foundation

Other organizations with this tax ID 7

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

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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587945600000",
    "number": "1114491636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3924 W ADAMS BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900181755",
            "telephone_number": "323-998-0654",
            "fax_number": "323-967-7746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3924 W ADAMS BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900181755",
            "telephone_number": "239-980-6543",
            "fax_number": "323-967-7746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL GROWTH FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MINDFUL GROWTH FOUNDATION",
        "enumeration_date": "2019-01-17",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A",
        "authorized_official_last_name": "SAMPSON",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-590-9813",
        "authorized_official_credential": "MSW/MPH"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MINDFUL GROWTH FOUNDATION #1",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 27, 2020; 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.