NPIMap

Organization Active NPI

Manifest Valley Wellness, LLC

Doing business as Manifest Recovery Centers

  • Community/Behavioral Health Agency
  • Tarzana, CA
National Provider Identifier
1568997633
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MANIFEST VALLEY WELLNESS, LLC
Doing business as
Manifest Recovery Centers
Practice address
18663 Ventura Blvd
Suite 300
Tarzana, CA 91356-4162
Phone
(818) 963-9319
Fax
(818) 657-7285
NPI assigned
Apr 26, 2017
Last updated
Dec 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Authorized official

Name
Brian Weiner
Title
Owner
Phone
(310) 905-4455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

18663 Ventura Blvd
Suite 300
Tarzana, CA 91356-4162

Mailing address

22647 Ventura Blvd
Unit 446
Woodland Hills, CA 91364-1416
Phone (310) 905-4455

Other names 1

  • Manifest Recovery Centers Doing business as

National Provider Directory

National Provider Directory

Locations

18663 Ventura Blvd
Ste 300
Tarzana, CA 91356
Phone (818) 963-9319

Practitioners & affiliated clinicians

Practitioners 9

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": "1493164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575417600000",
    "number": "1568997633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22647 VENTURA BLVD",
            "address_2": "UNIT 446",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641416",
            "telephone_number": "310-905-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18663 VENTURA BLVD",
            "address_2": "SUITE 300",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913564162",
            "telephone_number": "818-963-9319",
            "fax_number": "818-657-7285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANIFEST VALLEY WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-26",
        "last_updated": "2019-12-04",
        "status": "A",
        "authorized_official_last_name": "WEINER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-905-4455"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manifest Recovery Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Manifest Recovery Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tarzana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.