NPIMap

Organization Active NPI

Phoenix Houses of Los Angeles, Inc.

  • Substance Abuse Rehabilitation Facility
  • Venice, CA
National Provider Identifier
1497809735
Registry record updated Nov 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
190115AN Issued in CA
Legal business name
PHOENIX HOUSES OF LOS ANGELES, INC.
Practice address
503 Ocean Front Walk
Venice, CA 90291-2403
Phone
(310) 392-3070
Fax
(310) 392-9068
NPI assigned
Jan 23, 2007
Last updated
Nov 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2013

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

Authorized official

Name
Mr. Pouria Abbassi, P.E.
Title
Sr. Vice President, Regional Direct
Phone
(818) 686-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 190115AN CA Primary

Addresses

Primary practice location

503 Ocean Front Walk
Venice, CA 90291-2403

Mailing address

503 Ocean Front Walk
Venice, CA 90291-2403
Phone (310) 392-3070

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Houses of Los Angeles Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

503 Ocean Front Walk
Venice, CA 90291
Phone (310) 392-3070

Practitioners & affiliated clinicians

Practitioners 91

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.

View all 91

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385424000000",
    "number": "1497809735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 OCEAN FRONT WALK",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902912403",
            "telephone_number": "310-392-3070",
            "fax_number": "310-392-9068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 OCEAN FRONT WALK",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902912403",
            "telephone_number": "310-392-3070",
            "fax_number": "310-392-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HOUSES OF LOS ANGELES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2013-11-26",
        "status": "A",
        "authorized_official_last_name": "ABBASSI",
        "authorized_official_first_name": "POURIA",
        "authorized_official_title_or_position": "SR. VICE PRESIDENT, REGIONAL DIRECT",
        "authorized_official_telephone_number": "818-686-3000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.E."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190115AN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; 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.