Phoenix House Foundation

Primary specialty

Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X

Legal business name

PHOENIX HOUSE FOUNDATION

Practice address

11600 Eldridge Ave
Lake View Terrace, CA 91342-6506

Phone

(818) 686-3000

Fax

(818) 896-4232

NPI assigned

Oct 9, 2013

Organization subpart

No

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

Authorized official

Name

Christhopher Anderson, MA

Title

Director

Phone

(818) 686-3105

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1381276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381276800000",
    "number": "1639506520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11600 ELDRIDGE AVE",
            "city": "LAKE VIEW TERRACE",
            "state": "CA",
            "postal_code": "913426506",
            "telephone_number": "818-686-3000",
            "fax_number": "818-896-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 ELDRIDGE AVE",
            "city": "LAKE VIEW TERRACE",
            "state": "CA",
            "postal_code": "913426506",
            "telephone_number": "818-686-3000",
            "fax_number": "818-896-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HOUSE FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-09",
        "last_updated": "2013-10-09",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "CHRISTHOPHER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "818-686-3105",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Huma Pekcan
• Julissa Nohemi Pelayo
• Jessica Adelina Perez, BA
• Christie Perkins, MFT INTERN
• Phoenix House California - Lake View Terrace
• Phoenix Houses of Los Angeles
• Phoenix Houses of Los Angeles, Inc.
• Phoenix Houses of Los Angeles, Inc.
• Maritza Dalila Piedrasanta
• Natalie Grace Prater

• Children's Substance Abuse Rehabilitation Facility in Lake View Terrace, CA
• Providers in Lake View Terrace, CA by specialty
• Children's Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.