NPIMap

Organization Active NPI

Exodus Recovery, Inc.

  • Community/Behavioral Health Agency
  • Culver City, CA
National Provider Identifier
1164660528
Registry record updated Feb 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EXODUS RECOVERY, INC.
Practice address
9808 Venice Blvd
Suite 702
Culver City, CA 90232-2732
Phone
(310) 280-7006
Fax
(310) 840-7023
NPI assigned
Jan 23, 2009
Last updated
Feb 27, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2009

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

Authorized official

Name
Leeann Skorohod, CHCNPI 1386855732
Title
Sr VP, Operations
Phone
(310) 945-3350

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

9808 Venice Blvd
Suite 702
Culver City, CA 90232-2732

Mailing address

9808 Venice Blvd
Suite 702
Culver City, CA 90232-2732
Phone (310) 280-7006

Other identifiers 1

IdentifierTypeStateIssuer
C1432551OtherCACORPORATION ID#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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.

View all 24

National Provider Directory

National Provider Directory
Tax ID family
Exodus Recovery Inc44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

Locations

9808 Venice Blvd
Ste 702
Culver City, CA 90232
Phone (310) 280-7006

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235692800000",
    "number": "1164660528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9808 VENICE BLVD",
            "address_2": "SUITE 702",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322732",
            "telephone_number": "310-280-7006",
            "fax_number": "310-840-7023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9808 VENICE BLVD",
            "address_2": "SUITE 702",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322732",
            "telephone_number": "310-280-7006",
            "fax_number": "310-840-7023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXODUS RECOVERY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-23",
        "last_updated": "2009-02-27",
        "status": "A",
        "authorized_official_last_name": "SKOROHOD",
        "authorized_official_first_name": "LEEANN",
        "authorized_official_title_or_position": "SR VP, OPERATIONS",
        "authorized_official_telephone_number": "310-945-3350",
        "authorized_official_credential": "CHC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATION ID#",
            "identifier": "C1432551",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2009; 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.

Verify at the official NPI Registry.