NPIMap

Organization Active NPI

Pat Moore Detox, LLC

  • Substance Abuse Rehabilitation Facility
  • Encino, CA
National Provider Identifier
1801291737
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
190814AP Issued in CA
Legal business name
PAT MOORE DETOX, LLC
Practice address
4938 Rubio Ave
Encino, CA 91436-1121
Phone
(949) 646-2630
NPI assigned
Nov 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Authorized official

Name
Arel Meister-Aldama
Title
Board Director
Phone
(949) 646-2630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 190814AP CA Primary

Addresses

Primary practice location

4938 Rubio Ave
Encino, CA 91436-1121

Mailing address

4938 Rubio Ave
Encino, CA 91436-1121

National Provider Directory

National Provider Directory
Tax ID family
Pat Moore Detox LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1415059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415059200000",
    "number": "1801291737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4938 RUBIO AVE",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914361121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4938 RUBIO AVE",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914361121",
            "telephone_number": "949-646-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAT MOORE DETOX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-04",
        "last_updated": "2014-11-04",
        "status": "A",
        "authorized_official_last_name": "MEISTER-ALDAMA",
        "authorized_official_first_name": "AREL",
        "authorized_official_title_or_position": "BOARD DIRECTOR",
        "authorized_official_telephone_number": "949-646-2630"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190814AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; 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.