NPIMap

Organization Active NPI

Animo Locke Tech Charter High School

  • Community/Behavioral Health Agency
  • Los Angeles, CA
National Provider Identifier
1790050763
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
190622AN Issued in CA
Legal business name
ANIMO LOCKE TECH CHARTER HIGH SCHOOL
Practice address
810 E. 111TH Street
Room # 113 & 114
Los Angeles, CA 90001
Phone
(323) 585-8985
NPI assigned
Mar 9, 2012
Last updated
Mar 27, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
DIXON RECOVERY INSTITUTE,INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Authorized official

Name
Ms. Ronda Renee Dixon, JD
Title
Executive Director
Phone
(323) 988-3744

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 190622AN CA Primary

Addresses

Primary practice location

810 E. 111TH Street
Room # 113 & 114
Los Angeles, CA 90001

Mailing address

810 E. 111TH Street
Room # 113 & 114
Los Angeles, CA 90001
Phone (323) 585-8985

Other identifiers 2

IdentifierTypeStateIssuer
197336MedicaidCA
7336MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Shatto Street13 organizations share this tax ID, including this one
Part of
Shatto Street

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1331251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1790050763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 E. 111TH STREET",
            "address_2": "ROOM # 113 & 114",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90001",
            "telephone_number": "323-585-8985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 E. 111TH STREET",
            "address_2": "ROOM # 113 & 114",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90001",
            "telephone_number": "323-585-8985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANIMO LOCKE TECH CHARTER HIGH SCHOOL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIXON RECOVERY INSTITUTE,INC",
        "enumeration_date": "2012-03-09",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "RONDA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "EXECUTIVE  DIRECTOR",
        "authorized_official_telephone_number": "323-988-3744",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "190622AN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197336",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7336",
            "state": "CA"
        }
    ],
    "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 Mar 27, 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.