Casa Blanca Outpatient Services

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

CASA BLANCA OUTPATIENT SERVICES

Practice address

3246 Cahuenga Blvd W
Los Angeles, CA 90068-1302

Phone

(310) 795-4066

NPI assigned

Nov 8, 2018

Organization subpart

No

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

Authorized official

Name

Jason Vaughn Shoemaker, PHD

Title

Ceo

Phone

(310) 795-4066

Specialties & licenses 2

Addresses

Other names 1

• Universal Treatment Doing business as

Locations

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

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588723200000",
    "number": "1144798018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8033 W SUNSET BLVD # 946",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900462401",
            "telephone_number": "310-622-9795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3246 CAHUENGA BLVD W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900681302",
            "telephone_number": "310-795-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASA BLANCA OUTPATIENT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-08",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A",
        "authorized_official_last_name": "SHOEMAKER",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "VAUGHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-795-4066",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Universal Treatment",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Universal Treatment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Lyle Carver
• Cary Charlin D.D.S & Associaates, Inc
• Cary Charlin DDS Inc.
• Sarah J Cary, M.F.T.
• Casa Bella Sober Living - West, LLC
• Audra Jo Casabella, MSW
• Casablanca Outpatient
• Joseph Casaceli Jr.
• Thomas L Casados
• Jennilyn B. Casalme, CRNA

• 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 May 6, 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.