NPIMap

Organization Active NPI

Executive Recovery Group, Inc

Doing business as Executive Recovery Group -MH Outpt

  • Adult Mental Health Clinic/Center
  • Palm Desert, CA
National Provider Identifier
1871108928
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
EXECUTIVE RECOVERY GROUP, INC
Doing business as
Executive Recovery Group -MH Outpt
Practice address
77725 Enfield LN Ste 200
Palm Desert, CA 92211-0468
Phone
(818) 299-3602
Fax
(805) 830-1565
NPI assigned
Sep 14, 2020
Last updated
May 30, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
EXECUTIVE RECOVERY GROUP, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Authorized official

Name
Joann Zuniga
Title
Ur and Billing Director
Phone
(805) 437-6515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU Primary

Addresses

Primary practice location

77725 Enfield LN Ste 200
Palm Desert, CA 92211-0468

Mailing address

203 S Orange Dr
Los Angeles, CA 90036-3010
Phone (818) 299-3602

Other practice location 1

43875 Washington St
Palm Desert, CA 92211-8249
Phone (818) 299-3602

Other practice location 2

15613 Ventura Blvd
Encino, CA 91436-3128
Phone (818) 299-3602

Other names 1

  • Executive Recovery Group -MH Outpt Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Executive Recovery Group Inc9 organizations share this tax ID, including this one
Part of
Executive Recovery Group Inc

Other organizations with this tax ID 8

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

Locations

15613 Ventura Blvd
Encino, CA 91436
Phone (760) 409-1287

Practitioners & affiliated clinicians

Practitioners 3

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": "1600041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1871108928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S ORANGE DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900363010",
            "telephone_number": "818-299-3602",
            "fax_number": "805-830-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77725 ENFIELD LN STE 200",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922110468",
            "telephone_number": "818-299-3602",
            "fax_number": "805-830-1565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43875 Washington St",
            "address_purpose": "LOCATION",
            "city": "Palm Desert",
            "state": "CA",
            "postal_code": "922118249",
            "country_code": "US",
            "telephone_number": "818-299-3602",
            "fax_number": "805-830-1565",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15613 Ventura Blvd",
            "address_purpose": "LOCATION",
            "city": "Encino",
            "state": "CA",
            "postal_code": "914363128",
            "country_code": "US",
            "telephone_number": "818-299-3602",
            "fax_number": "805-830-1565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EXECUTIVE RECOVERY GROUP, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXECUTIVE RECOVERY GROUP, INC",
        "enumeration_date": "2020-09-14",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A",
        "authorized_official_last_name": "ZUNIGA",
        "authorized_official_first_name": "JOANN",
        "authorized_official_title_or_position": "UR AND BILLING DIRECTOR",
        "authorized_official_telephone_number": "805-437-6515"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Executive Recovery Group -MH Outpt",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Executive Recovery Group -MH Outpt",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palm Desert, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; 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.