EXODUS RECOVERY, INC. (NPI# 1083943005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083943005 |
| Entity Type | Organization |
| Organization Name | EXODUS RECOVERY, INC. |
| Other Organization Name | EXODUS CENTRAL CONNECTIONS |
| Practice Address |
4308 30th St Suite A San Diego CA 92104-1314 |
| Mailing Address |
9808 Venice Blvd Suite 700 Culver City CA 90232-2732 |
| Practice Telephone | 3109453350 |
| Mailing Telephone | 3109453350 |
| Mailing Fax Number | 3108407023 |
| Enumeration Date | 2009-12-22 |
| Last Update Date | 2013-07-12 |
| Authorized Official Name | MS. LEEANN SKOROHOD (SR VP OPERATIONS) |
| Authorized Official Telephone | 3109453350 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 3220 | 05 |
| Other Name | Type Code |
|---|---|
| Exodus Central Connections | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184272395 | Exodus Recovery, Inc. | Community/Behavioral Health | 550 W Vista Way Ste 204, Vista, CA 92083-5736 | 2019-08-30 |
| 1124596291 | Exodus Recovery, Inc. | Community/Behavioral Health | 550 W Vista Way Ste 109, Vista, CA 92083-5707 | 2018-11-07 |
| 1104307164 | Exodus Recovery, Inc. | Community/Behavioral Health | 1000 W Carson St Rm 2022, Bldg 2 South, Torrance, CA 90502-2004 | 2018-08-27 |
| 1740771559 | Exodus Recovery, Inc. | Community/Behavioral Health | 12021 S Wilmington Ave Fl 2, Ic1-ic7, Los Angeles, CA 90059-3019 | 2018-05-29 |
| 1184169815 | Exodus Recovery, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3754-56 Overland Ave, Los Angeles, CA 90034-6312 | 2017-01-04 |
| 1356711436 | Exodus Recovery, Inc. | Community/Behavioral Health | 8513 S Vermont Ave, Los Angeles, CA 90044-3425 | 2015-10-01 |
| 1053598979 | Exodus Recovery, Inc. | Community/Behavioral Health | 524 W Vista Way # 55, Vista, CA 92083-5704 | 2008-01-22 |
| 1437704806 | Exodus Recovery, Inc. | Community/Behavioral Health | 11905 S Central Ave Ste 303, Los Angeles, CA 90059-2897 | 2019-08-02 |
| 1235600545 | Exodus Recovery, Inc. | Community/Behavioral Health | 1520 S Escondido Blvd, Escondido, CA 92025-6017 | 2018-12-12 |
| 1114418928 | Exodus Recovery, Inc. | Community/Behavioral Health | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2018-05-29 |
| Street Address |
4308 30TH ST SUITE A |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92104-1314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750933610 | Hinderberger Dental Corporation | Dentist | 2050 El Cajon Boulevard, San Diego, CA 92104 | 2019-07-11 |
| 1912487265 | Graham Ashton Harris | Dentist | 2310 Craven Street, Bldg 3230, Fpo, AA 92104 | 2018-08-16 |
| 1700393485 | Christian Jacot | Occupational Therapy Assistant | 3128 Nile Street, San Diego, CA 92104 | 2018-01-04 |
| 1316452931 | Enrico Resurreccion Santos | Dental Hygienist | 2310 Craven St. Bldg. 3230, San Diego, CA 92104 | 2017-12-05 |
| 1164940789 | Robert Brian Damone | Acupuncturist | 3370 29th Street, San Diego, CA 92104 | 2017-09-04 |
| 1780100636 | Nicole Palacios | Counselor | 4170 Texas Street, Apt 1, San Diego, CA 92104 | 2017-08-22 |
| 1063938587 | Indie C Oliver Landrum | Case Manager/Care Coordinator | 2220 Broadway, San Diego, CA 92104 | 2017-08-16 |
| 1669829008 | Krystah Lynn Smith | Doula | 3370 Cherokee Ave, Unit 43, San Diego, CA 92104 | 2016-05-16 |
| 1063871853 | Holly Nicole Hinderberger | Dentist | 2050 El Cajon Blvd, San Diego, CA 92104 | 2016-02-22 |
| 1316336258 | Jorge E Talavera | Military Health Care Provider | 3875 Florida St Apt 2, San Diego, CA 92104 | 2015-01-15 |
| Find all providers in zip 92104 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134729718 | Cynthia Felicia Delaney | Community/Behavioral Health | 4887 Bella Pacific Row Unit 240, San Diego, CA 92109-8515 | 2020-10-31 |
| 1790390359 | Institute of Behavioral Sciences and Technology Family Counseling | Community/Behavioral Health | 9655 Granite Ridge Dr Ste Ofc2005, San Diego, CA 92123-2674 | 2020-09-10 |
| 1902426018 | Clayton Counseling Licensed Clinical Social Worker Inc. | Community/Behavioral Health | 2180 Garnet Ave Ste 2e, San Diego, CA 92109-3675 | 2020-04-17 |
| 1679113765 | Kristina Copley Marriage and Family Therapy, Inc | Community/Behavioral Health | 1267 Rosecrans St Ste B, San Diego, CA 92106-2692 | 2020-01-07 |
| 1417598319 | Open Heart Leaders | Community/Behavioral Health | 1913 Euclid Ave Ste 108, San Diego, CA 92105-5360 | 2019-10-01 |
| 1710531405 | Katherine Raftery | Community/Behavioral Health | 3570 Granada Ave, San Diego, CA 92104-4145 | 2019-07-31 |
| 1063064509 | Abigail Frances Swan | Community/Behavioral Health | 3376 Grim Ave Apt 3, San Diego, CA 92104-4650 | 2019-07-15 |
| 1548726862 | Unscripted Learning | Community/Behavioral Health | 3717 India St, San Diego, CA 92103-3727 | 2019-02-11 |
| 1356806509 | Vista Hill Foundation | Community/Behavioral Health | 8825 Aero Drive, Suite 315, San Diego, CA 92123-1104 | 2019-02-01 |
| 1891275707 | Kelley Kozlowski | Community/Behavioral Health | 4804 Iroquois Ave, San Diego, CA 92117-6248 | 2018-08-20 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.