NPIMap

Organization Active NPI

Innovate Recovery LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Van Nuys, CA
National Provider Identifier
1427791607
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
INNOVATE RECOVERY LLC
Practice address
14718 Keswick St
Van Nuys, CA 91405-1205
Phone
(181) 852-3002
NPI assigned
Apr 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Authorized official

Name
Ana Kesaryan
Title
Ceo
Phone
(818) 523-0025

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

14718 Keswick St
Van Nuys, CA 91405-1205

Mailing address

14718 Keswick St
Van Nuys, CA 91405-1205

National Provider Directory

National Provider Directory
Tax ID family
Innovate Recovery 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.

Locations

13737 Ventura Blvd
Sherman Oaks, CA 91423

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1649980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1427791607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14718 KESWICK ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914051205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14718 KESWICK ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914051205",
            "telephone_number": "181-852-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATE RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-15",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "KESARYAN",
        "authorized_official_first_name": "ANA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-523-0025"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.