NPIMap

Organization Active NPI

MJB Transitional Recovery, Inc.

  • Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1598118911
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
190288BN Issued in CA
Legal business name
MJB TRANSITIONAL RECOVERY, INC.
Practice address
11152 S Main St
Los Angeles, CA 90061-1953
Phone
(323) 777-2491
NPI assigned
Jul 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Authorized official

Name
Mr. Darrell Nelms, BA
Title
Executive Director
Phone
(323) 777-2491

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 190288BN CA Primary

Addresses

Primary practice location

11152 S Main St
Los Angeles, CA 90061-1953

Mailing address

11152 S Main St
Los Angeles, CA 90061-1953
Phone (323) 777-2491

National Provider Directory

National Provider Directory

Locations

11152 S Main St
Los Angeles, CA 90061
Phone (323) 777-2491

NPI Registry JSON

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468972800000",
    "number": "1598118911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11152 S MAIN ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900611953",
            "telephone_number": "323-777-2491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11152 S MAIN ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900611953",
            "telephone_number": "323-777-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MJB TRANSITIONAL RECOVERY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-20",
        "last_updated": "2016-07-20",
        "status": "A",
        "authorized_official_last_name": "NELMS",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "323-777-2491",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "190288BN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; 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.