Active NPI
Exodus Recovery, Inc.
- Community/Behavioral Health Agency
- Clovis, CA
National Provider Identifier
1144950411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- EXODUS RECOVERY, INC.
- Practice address
- 784 W Holland Ave
HSS Office and Community Room
Clovis, CA 93612 - Phone
- (559) 538-1230
- NPI assigned
- Jun 10, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Leeann Skorohod
- Title
- Coo
- Phone
- (310) 945-3350
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
784 W Holland Ave
HSS Office and Community Room
Clovis, CA 93612
Mailing address
9808 Venice Blvd Ste 700
Culver City, CA 90232-6824
Phone (310) 945-3350
Other names 1
- Butterfly Gardens
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100107000614 | CA | Part B Supplier - Clinic/Group Practice | 2668467341 |
Receives reassigned benefits from 30 practitioners 26 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Los Angeles, CA; Lynwood, CA; Orange, CA; Redondo Beach, CA; Vista, CA; Fresno, CA; Culver City, CA |
Other NPIs on the same Medicare enrollment 24
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Community/Behavioral Health Agency
- Los Angeles, CA
- NPI 1245441906
O20100107000614
-
- Community/Behavioral Health Agency
- Redondo Beach, CA
- NPI 1437360195
O20100107000614
-
- Community/Behavioral Health Agency
- Los Angeles, CA
- NPI 1700311073
O20100107000614
-
- Community/Behavioral Health Agency
- Culver City, CA
- NPI 1770623241
O20100107000614
-
- Community/Behavioral Health Agency
- Los Angeles, CA
- NPI 1962063123
O20100107000614
-
- Community/Behavioral Health Agency
- San Diego, CA
- NPI 1083943005
O20100107000614
-
- Community/Behavioral Health Agency
- Culver City, CA
- NPI 1164660528
O20100107000614
-
- Community/Behavioral Health Agency
- Redondo Beach, CA
- NPI 1265004584
O20100107000614
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654819200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1654819200000",
"number": "1144950411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9808 VENICE BLVD STE 700",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902326824",
"telephone_number": "310-945-3350",
"fax_number": "310-945-3355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "784 W HOLLAND AVE",
"address_2": "HSS OFFICE AND COMMUNITY ROOM",
"city": "CLOVIS",
"state": "CA",
"postal_code": "93612",
"telephone_number": "559-538-1230"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EXODUS RECOVERY, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2022-06-10",
"last_updated": "2022-06-10",
"certification_date": "2022-06-06",
"status": "A",
"authorized_official_last_name": "SKOROHOD",
"authorized_official_first_name": "LEEANN",
"authorized_official_title_or_position": "COO",
"authorized_official_telephone_number": "310-945-3350"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Butterfly Gardens",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Clovis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.