Elmo Detox

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

ELMO DETOX

Practice address

4646 St Elmo Dr
Los Angeles, CA 90019-5745

Phone

(310) 343-8684

NPI assigned

Nov 1, 2023

Organization subpart

No

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

Authorized official

Name

Nathan Young

Title

Manager

Phone

(310) 343-8684

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1698796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1912770975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 VINE ST STE 216",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900285250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 ST ELMO DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900195745",
            "telephone_number": "310-343-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMO DETOX",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-01",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "310-343-8684"
    },
    "taxonomies": [
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yasmeen O. Elmelige
• Lori A. Elmelund, M.F.T.
• Elmer E. Bangloy D.M.D., a Prof Corporation
• Cheryl Lynn Elmer, LMFT
• Elmnt Ir MD PC
• Emily Ann Elmore, AMFT
• Joann Grace Elmore
• Kelly Oberia Elmore, M.D.
• Paulla Elmore
• Ryan Elmore

• Substance Abuse Rehabilitation Facility in Los Angeles, CA
• Providers in Los Angeles, 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 Nov 20, 2023; 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.