SG Detox 5156 LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SG DETOX 5156 LLC

Practice address

5156 Bascule Ave
Woodland Hills, CA 91364-3447

Phone

(818) 456-4658

NPI assigned

Mar 9, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Adam Telanoff

Title

Ceo

Phone

(424) 272-1860

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1457481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457481600000",
    "number": "1780045302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 LINCOLN BLVD",
            "address_2": "#8",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904054620",
            "telephone_number": "424-272-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5156 BASCULE AVE",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913643447",
            "telephone_number": "818-456-4658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SG DETOX 5156 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-09",
        "last_updated": "2016-03-09",
        "status": "A",
        "authorized_official_last_name": "TELANOFF",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "424-272-1860",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Serrato
• Neha Vaneet Seth, MS, PT
• Jared Settles
• Patricia Eloisa Sevaaetasi
• Mahshid Seyedkazemi, PHARM.D.
• Helen Shaban, AUD
• Shadi Eliaspour DC
• Nena Rose Shadi, PHARMD
• Haleh Shafa, MD
• Karima Shagaga

• Substance Abuse Rehabilitation Facility in Woodland Hills, CA
• Providers in Woodland Hills, 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 Mar 9, 2016; 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.