Northstar Detox & Rehab Center, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

NORTHSTAR DETOX & REHAB CENTER, LLC

Practice address

19500 Winifred St
Tarzana, CA 91356-3815

Phone

(818) 928-2042

Fax

(818) 928-2043

NPI assigned

May 4, 2020

Last updated

Sep 23, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hossein Joukar, MD

Title

Medical Director

Phone

(305) 319-1133

Specialties & licenses 1

Addresses

Electronic endpoints 1

Tax ID family

Northstar Detox Rehab Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Northstar Detox & Rehab Center, LLC

  • Substance Abuse Rehabilitation Facility
  • Woodland Hills, CA
  • NPI 1912621129
  NPD tax ID

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

{
    "created_epoch": "1588550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663891200000",
    "number": "1326669011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19500 WINIFRED ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563815",
            "telephone_number": "818-928-2042",
            "fax_number": "818-928-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19500 WINIFRED ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563815",
            "telephone_number": "818-928-2042",
            "fax_number": "818-928-2043"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4610 Winnetka Ave",
            "address_purpose": "LOCATION",
            "city": "Woodland Hills",
            "state": "CA",
            "postal_code": "913644735",
            "country_code": "US",
            "telephone_number": "818-928-2058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHSTAR DETOX & REHAB CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-04",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-19",
        "status": "A",
        "authorized_official_last_name": "JOUKAR",
        "authorized_official_first_name": "HOSSEIN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "305-319-1133",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Tarzana",
            "affiliation": "N",
            "endpointDescription": "at facility and on EMR",
            "address_1": "19500 Winifred St",
            "city": "Tarzana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913563815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Tarzana, CA
• Providers in Tarzana, 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 Sep 23, 2022; 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.