NPIMap

Organization Active NPI

Bespoke Treatment LLC

  • Adult Mental Health Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1366052391
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
BESPOKE TREATMENT LLC
Practice address
12381 Wilshire Blvd Ste 205
Los Angeles, CA 90025-1063
Phone
(833) 867-2329
NPI assigned
Aug 4, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Authorized official

Name
Thi Hoang
Title
Business Office Representative
Phone
(702) 205-8232

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

12381 Wilshire Blvd Ste 205
Los Angeles, CA 90025-1063

Mailing address

12381 Wilshire Blvd Ste 205
Los Angeles, CA 90025-1063
Phone (833) 867-2329

Other practice location 1

250 E 1st St Ste 300
Los Angeles, CA 90012-3819
Phone (833) 867-2329

National Provider Directory

National Provider Directory
Tax ID family
Bespoke Treatment LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1596499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672099200000",
    "number": "1366052391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12381 WILSHIRE BLVD STE 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251063",
            "telephone_number": "833-867-2329",
            "fax_number": "833-867-3757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12381 WILSHIRE BLVD STE 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251063",
            "telephone_number": "833-867-2329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 E 1st St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900123819",
            "country_code": "US",
            "telephone_number": "833-867-2329",
            "fax_number": "833-867-3757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BESPOKE TREATMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-04",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A",
        "authorized_official_last_name": "HOANG",
        "authorized_official_first_name": "THI",
        "authorized_official_title_or_position": "BUSINESS OFFICE REPRESENTATIVE",
        "authorized_official_telephone_number": "702-205-8232"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 27, 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.