NPIMap

Organization Active NPI

Addiction Research and Treatment, Inc

Doing business as MedMark Treatment Centers Los Angeles

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1679062434
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
ADDICTION RESEARCH AND TREATMENT, INC
Doing business as
MedMark Treatment Centers Los Angeles
Practice address
11900 Avalon Blvd Ste 200&201
Los Angeles, CA 90061-2866
Phone
(214) 379-3398
Fax
(214) 550-2635
NPI assigned
May 8, 2018
Last updated
Jul 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
Bruce Jarvie
Title
VP, Treasurer
Phone
(214) 379-3300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

11900 Avalon Blvd Ste 200&201
Los Angeles, CA 90061-2866

Mailing address

1720 Lakepointe Dr Ste 117
Lewisville, TX 75057-6425
Phone (214) 379-3300

Other names 1

  • MedMark Treatment Centers Los Angeles Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200313001209 CA Part B Supplier - Opioid Treatment Program (Otp) 9931244753 17 other NPIs on this enrollment
Practice locations: Fresno, CA; Visalia, CA; San Francisco, CA; Richmond, CA; Porterville, CA; Oakland, CA; Menlo Park, CA; Lynwood, CA…

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 17

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
05D2154360Addiction Research and Treatment Inc11900 Avalon Boulevard Suite 200, Los Angeles, CA 90061Certificate of waiverSep 10, 2026

National Provider Directory

National Provider Directory
Tax ID family
Addiction Research and Treatment Inc20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Locations

3707 Sunset Ln
Ste Ab
Antioch, CA 94509
Phone (925) 522-0124

3711 Sunset Ln
Ste Ab
Antioch, CA 94509
Phone (323) 843-9013

2158 Solano Way
Concord, CA 94520
Phone (925) 690-5710

1235 E St
Fresno, CA 93706
Phone (559) 268-6261

539 N Van Ness Ave
Fresno, CA 93728
Phone (559) 265-2662

11900 Avalon Blvd
Ste 200201
Los Angeles, CA 90061
Phone (214) 379-3398

11682 Atlantic Ave
Lynwood, CA 90262
Phone (310) 537-5883

1646 S Court St
Visalia, CA 93277
Phone (559) 586-6767

Practitioners & affiliated clinicians

Practitioners 1

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": "1525737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1679062434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 LAKEPOINTE DR STE 117",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750576425",
            "telephone_number": "214-379-3300",
            "fax_number": "214-853-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 AVALON BLVD STE 200&201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900612866",
            "telephone_number": "214-379-3398",
            "fax_number": "214-550-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDICTION RESEARCH AND TREATMENT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-08",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "JARVIE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "VP, TREASURER",
        "authorized_official_telephone_number": "214-379-3300"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedMark Treatment Centers Los Angeles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.