NPIMap

Organization Active NPI

Restore Health and Wellness Center LLC

  • Substance Abuse Rehabilitation Facility
  • Los Angeles, CA
National Provider Identifier
1114637774
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
RESTORE HEALTH AND WELLNESS CENTER LLC
Practice address
4323 Coolidge Ave
Los Angeles, CA 90066
Phone
(818) 946-2772
NPI assigned
Dec 5, 2022
Organization subpart
Yes
Parent organization
RESTORE HEALTH AND WELLNESS CENTER LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Authorized official

Name
Eric J Leon
Title
Coo
Phone
(954) 641-5366

Specialties & licenses 1

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

Addresses

Primary practice location

4323 Coolidge Ave
Los Angeles, CA 90066

Mailing address

6918 Owensmouth Ave
Canoga Park, CA 91303-2003
Phone (818) 946-2772

National Provider Directory

National Provider Directory
Tax ID family
Restore Health and Wellness Center LLC10 organizations share this tax ID, including this one
Part of
Restore Health and Wellness Center LLC

Other organizations with this tax ID 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1114637774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6918 OWENSMOUTH AVE",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913032003",
            "telephone_number": "818-946-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4323 COOLIDGE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90066",
            "telephone_number": "818-946-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE HEALTH AND WELLNESS CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RESTORE HEALTH AND WELLNESS CENTER LLC",
        "enumeration_date": "2022-12-05",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A",
        "authorized_official_last_name": "LEON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "954-641-5366"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 17, 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.