NPIMap

Organization Active NPI

Exodus Recovery, Inc.

  • Community/Behavioral Health Agency
  • Lynwood, CA
National Provider Identifier
1174300412
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EXODUS RECOVERY, INC.
Practice address
3737 Martin Luther King Jr Blvd Ste 550
Lynwood, CA 90262-3536
Phone
(310) 341-1568
Fax
(323) 909-1796
NPI assigned
Sep 11, 2023
Last updated
Sep 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Authorized official

Name
Leeann Skorohod
Title
Cfo
Phone
(310) 945-3350

Specialties & licenses 1

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

Addresses

Primary practice location

3737 Martin Luther King Jr Blvd Ste 550
Lynwood, CA 90262-3536

Mailing address

9808 Venice Blvd Ste 700
Culver City, CA 90232-6824
Phone (310) 945-3350

Other names 1

  • Exodus HSSP Other name

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

10811 Washington Blvd
Ste 300
Culver City, CA 90232
Phone (424) 342-6900

660 E Grand Ave
Escondido, CA 92025
Phone (310) 945-2250

1902 Marengo St
#109110
Los Angeles, CA 90033
Phone (323) 276-6470

1902 Marengo St
Ste 200B
Los Angeles, CA 90033
Phone (323) 276-6490

1902 Marengo St
Ste 200C
Los Angeles, CA 90033
Phone (323) 276-6470

8513 S Vermont Ave
Los Angeles, CA 90044
Phone (323) 323-9426

3737 Martin Luther King Jr Blvd
Ste 550
Lynwood, CA 90262
Phone (310) 609-3890

923 S Catalina Ave
Redondo Beach, CA 90277
Phone (310) 792-5454

4308 30th St
San Diego, CA 92104

524 W Vista Way
Vista, CA 92083
Phone (760) 305-4900

Practitioners & affiliated clinicians

Practitioners 111

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.

View all 111

NPI Registry JSON

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1174300412",
    "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": "3737 MARTIN LUTHER KING JR BLVD STE 550",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623536",
            "telephone_number": "310-341-1568",
            "fax_number": "323-909-1796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXODUS RECOVERY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "SKOROHOD",
        "authorized_official_first_name": "LEEANN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "310-945-3350"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Exodus HSSP",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Exodus HSSP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lynwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.