Skyline Recovery Center

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SKYLINE RECOVERY CENTER

Practice address

1517 S Sepulveda Blvd
Los Angeles, CA 90025-3311

Phone

(626) 319-6296

NPI assigned

Feb 20, 2023

Organization subpart

No

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

Authorized official

Name

Ms. Zeena Foteh, N/A

Title

Administrator

Phone

(310) 686-9689

Specialties & licenses 2

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1760180699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 S SEPULVEDA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900253311",
            "telephone_number": "626-319-6296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 S SEPULVEDA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900253311",
            "telephone_number": "626-319-6296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYLINE RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-20",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "FOTEH",
        "authorized_official_first_name": "ZEENA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "310-686-9689",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "N/A"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURERS",
            "identifier": "INSURERS",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Boris Skuratovich
• Sky Diagnostics, Inc.
• Boris M Skyar, M.D.
• Skyfall Physical Therapy
• Skyline Healthcare & Wellness Center, LLC
• Skyline Sleep Center Apc
• Brian Skyy, DPT
• Ginger C Slack
• Margaret Carolyn Slack, MD
• Terri Ann Slade-Tucker

• Substance Abuse Rehabilitation Facility in Los Angeles, CA
• Providers in Los Angeles, 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 Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.