MC Intyre House

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

190420AN Issued in CA

Legal business name

MC INTYRE HOUSE

Practice address

544 N Kenmore Ave
Los Angeles, CA 90004-6815

Phone

(323) 662-0855

Fax

(323) 662-0842

NPI assigned

Nov 2, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Milton T Maristela, R.N.

Title

Executive Director

Phone

(323) 662-0855

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1376829432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 N KENMORE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900046815",
            "telephone_number": "323-662-0855",
            "fax_number": "323-662-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 N KENMORE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900046815",
            "telephone_number": "323-662-0855",
            "fax_number": "323-662-0842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MC INTYRE HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-02",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "MARISTELA",
        "authorized_official_first_name": "MILTON",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "323-662-0855",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190420AN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Somalia MC Clain
• Carol Anne MC Cleary, PHD
• Asia MC Cready
• Debresha MC Daniel, LCSW
• Sean Bartley MC Donald, P.C.C.
• Nicole C MC Mahon, LCSW
• Michael P. MC Nicoll, MD
• Diana MC Ryan, MSW
• Lamar McAdoo
• Alena McAdory

• 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 Nov 2, 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.