NPIMap

Organization Active NPI

Pride Health Services

  • Addiction (Substance Use Disorder) Counselor
  • Inglewood, CA
National Provider Identifier
1982822995
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
PRIDE HEALTH SERVICES
Practice address
8619 Crenshaw Blvd
Inglewood, CA 90305-2330
Phone
(310) 766-9019
Fax
(310) 677-9401
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Godfrey Nwogene
Title
Executive Director
Phone
(310) 677-9091

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X CA Primary

Addresses

Primary practice location

8619 Crenshaw Blvd
Inglewood, CA 90305-2330

Mailing address

8619 Crenshaw Blvd
Inglewood, CA 90305-2330
Phone (310) 766-9019

Other identifiers 1

IdentifierTypeStateIssuer
701231OtherCADRUG MEDI-CAL

Other names 1

  • Pride Health Services Crenshaw Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pride Health Services2 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.

Locations

8619 Crenshaw Blvd
Inglewood, CA 90305
Phone (310) 677-9019

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1982822995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8619 CRENSHAW BLVD",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903052330",
            "telephone_number": "310-766-9019",
            "fax_number": "310-677-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8619 CRENSHAW BLVD",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903052330",
            "telephone_number": "310-766-9019",
            "fax_number": "310-677-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIDE HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NWOGENE",
        "authorized_official_first_name": "GODFREY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "310-677-9091",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRUG MEDI-CAL",
            "identifier": "701231",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pride Health Services Crenshaw",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Inglewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.