Walking Miracles Foundation

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

190695 Issued in CA

Legal business name

WALKING MIRACLES FOUNDATION

Practice address

4067 W Third St
Los Angeles, CA 90265

Phone

(818) 635-9380

NPI assigned

Nov 30, 2011

Last updated

Nov 30, 2011By 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

Christopher Bathum, PHD

Title

Executive Board Member

Phone

(818) 635-9380

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1447527742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4067 W THIRD ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90265",
            "telephone_number": "818-635-9380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4067 W THIRD ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90265",
            "telephone_number": "818-635-9380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALKING MIRACLES FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-30",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "BATHUM",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "EXECUTIVE BOARD MEMBER",
        "authorized_official_telephone_number": "818-635-9380",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CA",
            "license": "190695",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190695",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valeri Dana Walker, M.D.
• Wendell Chevell Walker
• Zariah Walker
• Autumn Walkerly, PHARMD
• Walkers' Residential Care
• Emily Preston Walkley, LMFT
• Amanda Wall, PSY.D.
• Amanda Wall
• Britney Wall, LVN
• Charlotte Wall

• Substance Use Disorder Rehabilitation Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.