NPIMap

Organization Active NPI

Ultimate Lifestyle Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1720344716
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
ULTIMATE LIFESTYLE CENTER
Practice address
5012 S la Brea Ave
Los Angeles, CA 90056-1863
Phone
(323) 290-0200
NPI assigned
Apr 4, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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

Authorized official

Name
Masha Lisitsa, MFT
Title
Ceo
Phone
(323) 290-0200

Specialties & licenses 1

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

Addresses

Primary practice location

5012 S la Brea Ave
Los Angeles, CA 90056-1863

Mailing address

5012 S la Brea Ave
Los Angeles, CA 90056-1863
Phone (323) 290-0200

National Provider Directory

National Provider Directory
Tax ID family
Ultimate Lifestyle Center2 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.

Locations

5012 S La Brea Ave
Los Angeles, CA 90056
Phone (323) 290-0200

Practitioners & affiliated clinicians

Practitioners 4

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": "1333497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333497600000",
    "number": "1720344716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5012 S LA BREA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900561863",
            "telephone_number": "323-290-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5012 S LA BREA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900561863",
            "telephone_number": "323-290-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTIMATE LIFESTYLE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-04",
        "last_updated": "2012-04-04",
        "status": "A",
        "authorized_official_last_name": "LISITSA",
        "authorized_official_first_name": "MASHA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-290-0200",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 4, 2012; 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.