NPIMap

Organization Active NPI

Palm House, Inc.

  • Substance Abuse Rehabilitation Facility
  • Carson, CA
National Provider Identifier
1629441308
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
190040AN Issued in CA
Legal business name
PALM HOUSE, INC.
Practice address
2515 E Jefferson St
Carson, CA 90810-1519
Phone
(310) 830-7803
Fax
(310) 830-6606
NPI assigned
Nov 3, 2015
Last updated
Nov 3, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

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

Authorized official

Name
Mr. Renato Diccion Casaclang
Title
Executive Director
Phone
(310) 830-7803

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 190040AN CA Primary

Addresses

Primary practice location

2515 E Jefferson St
Carson, CA 90810-1519

Mailing address

2515 E Jefferson St
Carson, CA 90810-1519
Phone (310) 830-7803

National Provider Directory

National Provider Directory

Locations

2515 E Jefferson St
Long Beach, CA 90810
Phone (310) 830-7803

Practitioners & affiliated clinicians

Practitioners 8

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": "1446508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446508800000",
    "number": "1629441308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 E JEFFERSON ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "908101519",
            "telephone_number": "310-830-7803",
            "fax_number": "310-830-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 E JEFFERSON ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "908101519",
            "telephone_number": "310-830-7803",
            "fax_number": "310-830-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM HOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-03",
        "last_updated": "2015-11-03",
        "status": "A",
        "authorized_official_last_name": "CASACLANG",
        "authorized_official_first_name": "RENATO",
        "authorized_official_middle_name": "DICCION",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "310-830-7803",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190040AN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; 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.