White Oak Recovery Center LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

WHITE OAK RECOVERY CENTER LLC

Practice address

7838 Vantage Ave
North Hollywood, CA 91605-2408

Phone

(704) 450-2117

NPI assigned

Mar 12, 2020

Last updated

Nov 27, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dustin Johnson

Title

Ceo

Phone

(704) 450-2117

Specialties & licenses 1

Addresses

Tax ID family

White Oak Recovery Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• White Oak Recovery Center LLC

  • Adult Mental Health Clinic/Center
  • Van Nuys, CA
  • NPI 1801612445
  NPD tax ID

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732665600000",
    "number": "1710513593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 MASONBORO LOOP RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284093640",
            "telephone_number": "704-450-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7838 VANTAGE AVE",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916052408",
            "telephone_number": "704-450-2117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7840 Vantage Ave",
            "address_purpose": "LOCATION",
            "city": "North Hollywood",
            "state": "CA",
            "postal_code": "91605",
            "country_code": "US",
            "telephone_number": "704-450-2117",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6023 Hazeltine Ave",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914013525",
            "country_code": "US",
            "telephone_number": "704-450-2117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WHITE OAK RECOVERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-12",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-450-2117"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; 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.