NPIMap

Organization Active NPI

Executive Recovery Group, Inc

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Tarzana, CA
National Provider Identifier
1659863108
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Hospital UnitTaxonomy code 276400000X
Legal business name
EXECUTIVE RECOVERY GROUP, INC
Doing business as
Sanctuary Treatment Center
The Lake
Practice address
19233 White Stone CT
Tarzana, CA 91356-1131
Phone
(760) 409-1287
NPI assigned
May 31, 2018
Organization subpart
Yes
Parent organization
EXECUTIVE RECOVERY GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Authorized official

Name
Amy Crichton
Title
Executive Director
Phone
(760) 200-3839

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Substance Use Disorder Rehabilitation Hospital Unit 276400000X Primary

Addresses

Primary practice location

19233 White Stone CT
Tarzana, CA 91356-1131

Mailing address

19233 White Stone CT
Tarzana, CA 91356-1131
Phone (760) 409-1287

Other names 2

  • Sanctuary Treatment Center Doing business as
  • The Lake Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Executive Recovery Group Inc9 organizations share this tax ID, including this one
Part of
Executive Recovery Group Inc

Other organizations with this tax ID 8

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1659863108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19233 WHITE STONE CT",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913561131",
            "telephone_number": "760-409-1287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19233 WHITE STONE CT",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913561131",
            "telephone_number": "760-409-1287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE RECOVERY GROUP, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXECUTIVE RECOVERY GROUP, INC.",
        "enumeration_date": "2018-05-31",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "CRICHTON",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "760-200-3839"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sanctuary Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Lake",
            "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 Feb 10, 2022; 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.