NPIMap

Organization Active NPI

Exodus Recovery Inc.

  • Community/Behavioral Health Agency
  • Lynwood, CA
National Provider Identifier
1821225616
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EXODUS RECOVERY INC.
Practice address
3737 Martin Luther King Jr Blvd Ste 525
Lynwood, CA 90262-3535
Phone
(310) 733-7981
Fax
(323) 312-0188
NPI assigned
Jun 18, 2009
Last updated
Sep 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Authorized official

Name
Leeann Skorohod
Title
Cfo
Phone
(310) 945-3350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

3737 Martin Luther King Jr Blvd Ste 525
Lynwood, CA 90262-3535

Mailing address

9808 Venice Blvd
Suite 700
Culver City, CA 90232-2732
Phone (310) 945-3350

Other identifiers 1

IdentifierTypeStateIssuer
7774AMedicaidCA

Other names 1

  • PEJ Exodus Wellness Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100107000614 CA Part B Supplier - Clinic/Group Practice 2668467341 Receives reassigned benefits from 30 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Los Angeles, CA; Lynwood, CA; Orange, CA; Redondo Beach, CA; Vista, CA; Fresno, CA; Culver City, CA

Other NPIs on the same Medicare enrollment 24

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 24

National Provider Directory

National Provider Directory
Tax ID family
Exodus Recovery Inc44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

Locations

11905 S Central Ave
Ste 204
Los Angeles, CA 90059
Phone (213) 200-7174

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/exodusrecovery/r4/

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1821225616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9808 VENICE BLVD",
            "address_2": "SUITE 700",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322732",
            "telephone_number": "310-945-3350",
            "fax_number": "310-840-7023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 MARTIN LUTHER KING JR BLVD STE 525",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623535",
            "telephone_number": "310-733-7981",
            "fax_number": "323-312-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXODUS RECOVERY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-18",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "SKOROHOD",
        "authorized_official_first_name": "LEEANN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "310-945-3350"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7774A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEJ Exodus Wellness Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "PEJ Exodus Wellness Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lynwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.