NPIMap

Organization Active NPI

Exodus Foundation

Doing business as Exodus Foundation for Recovery

  • Community/Behavioral Health Agency
  • Los Angeles, CA
National Provider Identifier
1255732962
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EXODUS FOUNDATION
Doing business as
Exodus Foundation for Recovery
Practice address
12021 S Wilmington Ave
2ND Floor Ic1-Ic7
Los Angeles, CA 90059-3019
Phone
(562) 295-5916
Fax
(562) 295-5965
NPI assigned
Sep 12, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Authorized official

Name
Leeann SkorohodNPI 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 connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

12021 S Wilmington Ave
2ND Floor Ic1-Ic7
Los Angeles, CA 90059-3019

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
7890MedicaidCA

Other names 1

  • Exodus Foundation for Recovery Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1410480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482278400000",
    "number": "1255732962",
    "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": "310-840-7023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12021 S WILMINGTON AVE",
            "address_2": "2ND FLOOR IC1-IC7",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593019",
            "telephone_number": "562-295-5916",
            "fax_number": "562-295-5965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXODUS FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-12",
        "last_updated": "2016-12-21",
        "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"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Exodus Foundation for Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; 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.