Mariposa Detox Center LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

MARIPOSA DETOX CENTER LLC

Practice address

832 N Mariposa Ave
Los Angeles, CA 90029-3405

Phone

(561) 563-6582

NPI assigned

May 12, 2020

Organization subpart

No

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

Authorized official

Name

Brandan Freeman

Title

Ceo

Phone

(631) 245-0911

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603324800000",
    "number": "1932721099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "832 N MARIPOSA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900293405",
            "telephone_number": "561-563-6582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 N MARIPOSA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900293405",
            "telephone_number": "561-563-6582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIPOSA DETOX CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-12",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "BRANDAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "631-245-0911"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marion Dunham Acupuncture Inc.
• Dana Patrice Marion
• Frances Marion, LCSW
• Ingrid Thayana Mariona Gomez, MD
• Mariposa Detox Center II LLC
• Mariposa Pharmacy LTD
• Adrianna Janette Mariscal
• Alondra Eleonor Mariscal
• Amanda Mariscal
• Lizet Mariscal

• 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 Oct 22, 2020; 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.