NPIMap

Organization Active NPI

Chabad Residential Treatment Center

  • Substance Abuse Rehabilitation Facility
  • Los Angeles, CA
National Provider Identifier
1841429669
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
190087CN Issued in CA
Legal business name
CHABAD RESIDENTIAL TREATMENT CENTER
Practice address
5675 W Olympic Blvd
Los Angeles, CA 90036-4712
Phone
(323) 965-1365
Fax
(323) 965-0444
NPI assigned
Jul 14, 2009
Organization subpart
Yes
Parent organization
CHABAD OF CALIFORNIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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

Authorized official

Name
Ms. Donna Lynn Miller, MFT
Title
Clinical Director
Phone
(323) 965-1365

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 190087CN CA Primary

Addresses

Primary practice location

5675 W Olympic Blvd
Los Angeles, CA 90036-4712

Mailing address

5675 W Olympic Blvd
Los Angeles, CA 90036-4712
Phone (323) 965-1365

National Provider Directory

National Provider Directory
Tax ID family
Chabad Residential Treatment Center2 organizations share this tax ID, including this one
Part of
Chabad Residential Treatment Center

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459382400000",
    "number": "1841429669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5675 W OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364712",
            "telephone_number": "323-965-1365",
            "fax_number": "323-965-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5675 W OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364712",
            "telephone_number": "323-965-1365",
            "fax_number": "323-965-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHABAD RESIDENTIAL TREATMENT CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHABAD OF CALIFORNIA",
        "enumeration_date": "2009-07-14",
        "last_updated": "2016-03-31",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "323-965-1365",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190087CN",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 31, 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.