NPIMap

Organization Active NPI

Exodus Recovery, Inc.

  • Community/Behavioral Health Agency
  • Vista, CA
National Provider Identifier
1659049807
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EXODUS RECOVERY, INC.
Practice address
524 W Vista Way
Vista, CA 92083-5704
Phone
(760) 758-1150
Fax
(760) 758-1808
NPI assigned
Sep 2, 2021
Last updated
Sep 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Authorized official

Name
Leeann Skorohod
Title
Coo
Phone
(310) 945-3350

Specialties & licenses 1

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

Addresses

Primary practice location

524 W Vista Way
Vista, CA 92083-5704

Mailing address

9808 Venice Blvd Ste 700
Culver City, CA 90232-6824
Phone (310) 945-3350

Other names 1

  • Vista Behavioral Health Crisis Stabilization Unit Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2258592Exodus Recovery Vista Behavioral Health Crisis524 West Vista Way, Vista, CA 92083Certificate of waiverApr 24, 2028

National Provider Directory

National Provider Directory
Tax ID family
Exodus Recovery Inc44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630540800000",
    "number": "1659049807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9808 VENICE BLVD STE 700",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902326824",
            "telephone_number": "310-945-3350",
            "fax_number": "310-945-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 W VISTA WAY",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920835704",
            "telephone_number": "760-758-1150",
            "fax_number": "760-758-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXODUS RECOVERY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-08-17",
        "status": "A",
        "authorized_official_last_name": "SKOROHOD",
        "authorized_official_first_name": "LEEANN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "310-945-3350"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vista Behavioral Health Crisis Stabilization Unit",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.