Iris Healing Retreat LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

IRIS HEALING RETREAT LLC

Practice address

5663 Jumilla Ave
Woodland Hills, CA 91367-6910

Phone

(323) 449-0016

Fax

(818) 301-1940

NPI assigned

Jul 28, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Elena Kapustina, PSYD

Title

Ceo

Phone

(323) 449-0016

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1861945560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23033 OSTRONIC DR",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913676143",
            "telephone_number": "818-436-2646",
            "fax_number": "818-301-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5663 JUMILLA AVE",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913676910",
            "telephone_number": "323-449-0016",
            "fax_number": "818-301-1940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23033 Ostronic Dr",
            "address_purpose": "LOCATION",
            "city": "Woodland Hills",
            "state": "CA",
            "postal_code": "913676143",
            "country_code": "US",
            "telephone_number": "818-436-2646",
            "fax_number": "818-301-1940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IRIS HEALING RETREAT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "KAPUSTINA",
        "authorized_official_first_name": "ELENA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-449-0016",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Intuitive Psychotherapy Associates, Licensed Clinical Social Worker PC
• Arika Inugami
• Xavier Anthony Ippolito
• Cesar David Iraheta Urbina
• Iris Healing Center LLC
• Irit Bar-Netzer
• Heidi Irwin
• Megan Louise Isham
• Armine Ishtoyan, PHARM.D.
• Raymond R. Iskander, D.C.

• 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 Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.