NPIMap

Organization Active NPI

Klean W. Hollywood

  • Substance Abuse Rehabilitation Facility
  • West Hollywood, CA
National Provider Identifier
1891093563
Registry record updated Mar 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
190692BP Issued in CA
Legal business name
KLEAN W. HOLLYWOOD
Practice address
840 Hilldale Ave
West Hollywood, CA 90069-4940
Phone
(310) 492-9820
NPI assigned
Mar 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2011

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

Authorized official

Name
Mr. Darryl Booth
Title
Director of Operations
Phone
(310) 922-2264

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 190692BP CA Primary

Addresses

Primary practice location

840 Hilldale Ave
West Hollywood, CA 90069-4940

Mailing address

8543 Santa Monica Blvd
West Hollywood, CA 90069-4150
Phone (310) 855-7140

National Provider Directory

National Provider Directory
Tax ID family
Klean W Hollywood8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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": "1299196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299196800000",
    "number": "1891093563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8543 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900694150",
            "telephone_number": "310-855-7140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 HILLDALE AVE",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900694940",
            "telephone_number": "310-492-9820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLEAN W. HOLLYWOOD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-04",
        "last_updated": "2011-03-04",
        "status": "A",
        "authorized_official_last_name": "BOOTH",
        "authorized_official_first_name": "DARRYL",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "310-922-2264",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190692BP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2011; 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.