22703 Sylvan Street Detox LLC

Key facts

NPI

1760053391

Entity type

Organization (NPI type 2)

Primary specialty

Substance Abuse Rehabilitation Facility 324500000X

Legal business name

22703 SYLVAN STREET DETOX LLC

Practice address

22703 Sylvan St
Woodland Hills, CA 91367-1625

Phone

(828) 367-8727

NPI assigned

Jul 6, 2021

Organization subpart

No

Authorized official

Name

Daniel Keane

Title

Coo

Phone

(424) 229-2061

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 11, 2023.

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1760053391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22703 SYLVAN ST",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913671625",
            "telephone_number": "424-229-2061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22703 SYLVAN ST",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913671625",
            "telephone_number": "828-367-8727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "22703 SYLVAN STREET DETOX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-06",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A",
        "authorized_official_last_name": "KEANE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "424-229-2061"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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