Chabad of California

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

190087DN Issued in CA

Legal business name

CHABAD OF CALIFORNIA

Doing business as

Chabad Treatment Center

Practice address

1750 S la Cienega Blvd
Los Angeles, CA 90035-4602

Phone

(323) 965-1365

NPI assigned

Jul 19, 2016

Organization subpart

No

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

Authorized official

Name

Mr. David Kovi Blauner

Title

Administrator

Phone

(323) 965-1365

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Chabad Treatment Center Doing business as

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

CLIA laboratory certificates

Tax ID family

Chabad Residential Treatment Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Chabad Residential Treatment Center

  • Substance Abuse Rehabilitation Facility
  • Los Angeles, CA
  • NPI 1841429669
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Chabad Residential Treatment Center

  • Substance Abuse Rehabilitation Facility
  • Los Angeles, CA
  • NPI 1841429669
  NPPES parent name

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468886400000",
    "number": "1922451574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 S LA CIENEGA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900354602",
            "telephone_number": "323-965-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 S LA CIENEGA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900354602",
            "telephone_number": "323-965-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHABAD OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-19",
        "last_updated": "2016-07-19",
        "status": "A",
        "authorized_official_last_name": "BLAUNER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "KOVI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "323-965-1365",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CA",
            "license": "190087DN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "190087DN",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chabad Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Justin Cha
• Min Y Cha, M.D.
• Myung S Cha, DDS
• Nisha S Cha
• Ali Ahmad Chaaban, DPM
• Chabad Residential Treatment Center
• Mukda Chabairum
• Gabriela Chabolla Razo
• Grace Dayanara Chacon-Cruz
• Ronaldy Jose Chacon-Diaz

• Substance Use Disorder Rehabilitation Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; 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.