Saint Lawrence Recovery

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SAINT LAWRENCE RECOVERY

Practice address

12437 Huston St
Valley Village, CA 91607-3517

Phone

(747) 250-4884

NPI assigned

Oct 11, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Lawrence Ksido

Title

Ceo

Phone

(747) 250-4884

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

Locations

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

{
    "created_epoch": "1696982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1508647918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14617 ARMINTA ST",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914025901",
            "telephone_number": "747-250-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12437 HUSTON ST",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073517",
            "telephone_number": "747-250-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT LAWRENCE RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-11",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "KSIDO",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-250-4884",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "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": []
}

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• Substance Abuse Rehabilitation Facility in Valley Village, CA
• Providers in Valley Village, 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 Oct 11, 2023; 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.