NPIMap

Organization Active NPI

Klean W. Hollywood

  • Substance Abuse Rehabilitation Facility
  • West Hollywood, CA
National Provider Identifier
1265731368
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
190692DP Issued in CA
Legal business name
KLEAN W. HOLLYWOOD
Practice address
846 Hilldale Ave
West Hollywood, CA 90069-4907
Phone
(310) 492-9820
NPI assigned
Mar 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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

Authorized official

Name
Mr. Darryl Booth
Title
Director of Operations
Phone
(310) 492-9824

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 190692DP CA Primary

Addresses

Primary practice location

846 Hilldale Ave
West Hollywood, CA 90069-4907

Mailing address

8543 Santa Monica Blvd
Suite 11
W Hollywood, CA 90069-4150
Phone (310) 492-9820

National Provider Directory

National Provider Directory
Tax ID family
Klean W Hollywood8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1300147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300147200000",
    "number": "1265731368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8543 SANTA MONICA BLVD",
            "address_2": "SUITE 11",
            "city": "W HOLLYWOOD",
            "state": "CA",
            "postal_code": "900694150",
            "telephone_number": "310-492-9820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "846 HILLDALE AVE",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900694907",
            "telephone_number": "310-492-9820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLEAN W. HOLLYWOOD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-15",
        "last_updated": "2011-03-15",
        "status": "A",
        "authorized_official_last_name": "BOOTH",
        "authorized_official_first_name": "DARRYL",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "310-492-9824",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190692DP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; 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.