NPIMap

Organization Active NPI

Alta Centers, Inc.

  • Substance Abuse Rehabilitation Facility
  • Encino, CA
National Provider Identifier
1487020343
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
190852 Issued in CA
Legal business name
ALTA CENTERS, INC.
Practice address
5435 Balboa Blvd
Suite 103
Encino, CA 91316-1508
Phone
(818) 616-7443
Fax
(818) 301-2046
NPI assigned
Aug 14, 2015
Last updated
Jun 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Anna Van Kovn
Title
Ceo
Phone
(818) 616-7443

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 190852 CA Primary

Addresses

Primary practice location

5435 Balboa Blvd
Suite 103
Encino, CA 91316-1508

Mailing address

5435 Balboa Blvd
Suite 103
Encino, CA 91316-1508
Phone (818) 616-7443

Other practice location 1

6100 Rodgerton Dr
Los Angeles, CA 90068-1964
Phone (818) 616-7443

National Provider Directory

National Provider Directory
Tax ID family
Alta Centers Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

5435 Balboa Blvd
Ste 103
Encino, CA 91316
Phone (818) 616-7443

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1439510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1487020343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5435 BALBOA BLVD",
            "address_2": "SUITE 103",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913161508",
            "telephone_number": "818-616-7443",
            "fax_number": "818-301-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5435 BALBOA BLVD",
            "address_2": "SUITE 103",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913161508",
            "telephone_number": "818-616-7443",
            "fax_number": "818-301-2046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6100 Rodgerton Dr",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900681964",
            "country_code": "US",
            "telephone_number": "818-616-7443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALTA CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-14",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "VAN KOVN",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-616-7443"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.