Los Angeles Detox LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

LOS ANGELES DETOX LLC

Practice address

522 N Larchmont Blvd
Los Angeles, CA 90004-1306

Phone

(562) 912-0291

NPI assigned

Apr 14, 2015

Last updated

Apr 14, 2015By 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

Keith Ronald Fowler

Title

Ceo

Phone

(562) 912-0291

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1346636537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 N LARCHMONT BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900041306",
            "telephone_number": "562-912-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 N LARCHMONT BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900041306",
            "telephone_number": "562-912-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES DETOX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-14",
        "last_updated": "2015-04-14",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "RONALD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-912-0291"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Los Angeles County, University of Southern California Hospital
• Los Angeles Department of Medical Examiner-Coroner
• Los Angeles Department of Mental Health
• Los Angeles Department of Mental Health
• Los Angeles Detox and Treatment Center
• Los Angeles Diabetes Associates, Inc.
• Los Angeles Diagnostics
• Los Angeles Dialysis Center
• Los Angeles Doctors Clinic
• Los Angeles Doctors Corp (Los Angeles Metropolitan Medical Center)

• 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 Apr 14, 2015; 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.