NPIMap

Organization Active NPI

Didi Hirsch Psychiatric Service

  • Mental Illness Community Based Residential Treatment Facility
  • Inglewood, CA
National Provider Identifier
1467583518
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
DIDI HIRSCH PSYCHIATRIC SERVICE
Practice address
1007 Myrtle Ave
Inglewood, CA 90301-4009
Phone
(310) 412-4191
Fax
(310) 412-3942
NPI assigned
Mar 8, 2007
Last updated
Oct 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Authorized official

Name
Dulce M Ruiz
Title
Contracts & Grants Manager
Phone
(310) 751-5442

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

1007 Myrtle Ave
Inglewood, CA 90301-4009

Mailing address

4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone (310) 390-6612

Other names 1

  • Didi Hirsch Excelsior House Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050616000752 CA Part B Supplier - Clinic/Group Practice 3870537194 Receives reassigned benefits from 39 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Glendale, CA; Pacoima, CA; Los Angeles, CA; Inglewood, CA; Culver City, CA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Cac Didi Hirsch Suicide Support Services32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

Practitioners & affiliated clinicians

Practitioners 10

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": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601942400000",
    "number": "1467583518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304820",
            "telephone_number": "310-390-6612",
            "fax_number": "310-398-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 MYRTLE AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014009",
            "telephone_number": "310-412-4191",
            "fax_number": "310-412-3942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIDI HIRSCH PSYCHIATRIC SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A",
        "authorized_official_last_name": "RUIZ",
        "authorized_official_first_name": "DULCE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CONTRACTS & GRANTS MANAGER",
        "authorized_official_telephone_number": "310-751-5442"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Didi Hirsch Excelsior House",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Didi Hirsch Excelsior House",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Inglewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.