Iris Healing Center LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

IRIS HEALING CENTER LLC

Practice address

20300 Ventura Blvd Ste 300
Woodland Hills, CA 91364-0901

Phone

(323) 449-0016

Fax

(323) 449-0016

NPI assigned

Nov 30, 2017

Last updated

Jul 2, 2022By 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

Dr. Elena Kapustina, PSYD

Title

Ceo

Phone

(323) 449-0016

Specialties & licenses 3

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656720000000",
    "number": "1144734922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20300 VENTURA BLVD STE 300",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913640901",
            "telephone_number": "323-449-0016",
            "fax_number": "818-301-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20300 VENTURA BLVD STE 300",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913640901",
            "telephone_number": "323-449-0016",
            "fax_number": "323-449-0016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRIS HEALING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-30",
        "last_updated": "2022-07-02",
        "certification_date": "2022-07-02",
        "status": "A",
        "authorized_official_last_name": "KAPUSTINA",
        "authorized_official_first_name": "ELENA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-449-0016",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Arika Inugami
• Xavier Anthony Ippolito
• Cesar David Iraheta Urbina
• Iris Healing Retreat LLC
• Irit Bar-Netzer
• Heidi Irwin
• Megan Louise Isham
• Armine Ishtoyan, PHARM.D.

• Substance Abuse Rehabilitation Facility in Woodland Hills, CA
• Providers in Woodland Hills, 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 Jul 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.