NPIMap

Organization Active NPI

Phoenix Houses of Los Angeles

  • Children's Substance Abuse Rehabilitation Facility
  • Lake View Terrace, CA
National Provider Identifier
1700226685
Registry record updated Dec 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X
License
190115DN Issued in CA
Legal business name
PHOENIX HOUSES OF LOS ANGELES
Practice address
11465 Kagel Canyon St
Lake View Terrace, CA 91342-6505
Phone
(818) 686-3000
NPI assigned
Jun 25, 2013
Last updated
Dec 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2013

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

Authorized official

Name
Elizabeth Salazar, MPH
Title
Regional Clinical Director
Phone
(818) 686-3015

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Substance Abuse Rehabilitation Facility 3245S0500X 190115DN CA Primary

Addresses

Primary practice location

11465 Kagel Canyon St
Lake View Terrace, CA 91342-6505

Mailing address

11600 Eldridge Ave
Lake View Terrace, CA 91342-6506
Phone (818) 686-3000

Other identifiers 1

IdentifierTypeStateIssuer
1945OtherCAMEDICAL

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Houses of Los Angeles Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385942400000",
    "number": "1700226685",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11465 KAGEL CANYON ST",
            "city": "LAKE VIEW TERRACE",
            "state": "CA",
            "postal_code": "913426505",
            "telephone_number": "818-686-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HOUSES OF LOS ANGELES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-25",
        "last_updated": "2013-12-02",
        "status": "A",
        "authorized_official_last_name": "SALAZAR",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "REGIONAL CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "818-686-3015",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "CA",
            "license": "190115DN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "1945",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake View Terrace, CA

Sources for this page

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