Mariposa Detox Center II LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

MARIPOSA DETOX CENTER II LLC

Practice address

739 N Mariposa Ave
Los Angeles, CA 90029-3485

Phone

(855) 740-1181

NPI assigned

Nov 18, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Brandan Freeman

Title

Ceo

Phone

(855) 740-1181

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637193600000",
    "number": "1235896879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 N MARIPOSA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900293485",
            "telephone_number": "855-740-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 N MARIPOSA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900293485",
            "telephone_number": "855-740-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIPOSA DETOX CENTER II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-18",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "BRANDAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "855-740-1181",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Frances Marion, LCSW
• Ingrid Thayana Mariona Gomez, MD
• Mariposa Detox Center LLC
• Mariposa Pharmacy LTD
• Adrianna Janette Mariscal
• Alondra Eleonor Mariscal
• Amanda Mariscal

• 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 Nov 18, 2021; 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.