Annandale Behavioral Health, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

ANNANDALE BEHAVIORAL HEALTH, LLC

Practice address

1280 Afton St
Pasadena, CA 91103-2303

Phone

(312) 092-2226

NPI assigned

Dec 15, 2019

Last updated

Feb 7, 2024By 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

Mr. Darryl Olivier

Title

Ceo

Phone

(310) 922-2264

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1576368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1437797024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 PORTIA ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900262651",
            "telephone_number": "310-922-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 AFTON ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911032303",
            "telephone_number": "312-092-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNANDALE BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-15",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "OLIVIER",
        "authorized_official_first_name": "DARRYL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-922-2264",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Anguiano
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• Anne B. Simpson, PH.D.
• Anne Crile LMFT a Marriage & Family Therapy Corporation
• Annette Champo, CLMT
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• Jackie Ante

• Substance Abuse Rehabilitation Facility in Pasadena, CA
• Providers in Pasadena, 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 Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.