PHOENIX HOUSES OF LOS ANGELES, INC. (NPI# 1427594639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427594639 |
| Entity Type | Organization |
| Organization Name | PHOENIX HOUSES OF LOS ANGELES, INC. |
| Other Organization Name | PHOENIX ACADEMY AT LAKE VIEW TERRACE |
| Practice Address |
11600 Eldridge Ave Lake View Terrace CA 91342-6506 |
| Practice Telephone | 8186863000 |
| Practice Fax Number | 8188964859 |
| Mailing Telephone | 8186863000 |
| Mailing Fax Number | 8186863016 |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2018-04-23 |
| Authorized Official Name | MS. SHAWNA RENEE MORRIS (SENIOR VICE PRESIDENT AND EXECUTIVE) |
| Authorized Official Telephone | 8186863011 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
191222731 | CA | Residential Treatment Facilities |
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 190115BN | CA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Phoenix Academy at Lake View Terrace | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497809735 | Phoenix Houses of Los Angeles, Inc. | Substance Abuse Rehabilitation Facility | 503 Ocean Front Walk, Venice, CA 90291-2403 | 2007-01-23 |
| 1235283722 | Phoenix Houses of Los Angeles, Inc. | Substance Abuse Rehabilitation Facility | 11600 Eldridge Ave, Lake View Terrace, CA 91342-6506 | 2007-01-22 |
| 1437205408 | Phoenix Houses of Los Angeles, Inc. | Substance Abuse Rehabilitation Facility | 11015 Bloomfield Ave, Santa Fe Springs, CA 90670-4601 | 2007-01-25 |
| Street Address |
11600 ELDRIDGE AVE |
| City | LAKE VIEW TERRACE |
| State | CA |
| Zip Code | 91342-6506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235283722 | Phoenix Houses of Los Angeles, Inc. | Substance Abuse Rehabilitation Facility | 11600 Eldridge Ave, Lake View Terrace, CA 91342-6506 | 2007-01-22 |
| 1093326787 | Stella Dorin | Student in an Organized Health Care Education/Training Program | 11600 Eldridge Ave, Lake View Terrace, CA 91342-6506 | 2020-08-14 |
| 1235740226 | Elizabeth Catherine Wight | Student in an Organized Health Care Education/Training Program | 11600 Eldridge Ave, Lake View Terrace, CA 91342-6506 | 2020-08-12 |
| 1881205870 | Julissa Nohemi Pelayo | Student in an Organized Health Care Education/Training Program | 11600 Eldridge Ave, Lake View Terrace, CA 91342-6506 | 2020-08-12 |
| 1992322325 | Lizeth Elena Lomeli | Social Worker | 11600 Eldridge Ave, Lake View Terrace, CA 91342-6506 | 2020-07-01 |
| 1467075051 | Timothy Oh | Student in an Organized Health Care Education/Training Program | 11600 Eldridge Ave, Lake View Terrace, CA 91342-6506 | 2020-05-19 |
| 1649892654 | Jennifer Miranda Kashou | Student in an Organized Health Care Education/Training Program | 11600 Eldridge Ave, Lake View Terrace, CA 91342-6506 | 2020-05-13 |
| 1710509625 | Araceli L Pimentel | Student in an Organized Health Care Education/Training Program | 11600 Eldridge Ave, Lake View Terrace, CA 91342-6506 | 2020-05-13 |
| 1790306785 | Julian Rocha | Student in an Organized Health Care Education/Training Program | 11600 Eldridge Ave, Lake View Terrace, CA 91342-6506 | 2020-04-30 |
| 1194367110 | Florencia Lucy Gonzalez | Counselor | 11600 Eldridge Ave, Lake View Terrace, CA 91342-6506 | 2019-10-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629687223 | Evelyn Pinto Morales | Technician, Other | 14445 Olive View Dr, Sylmar, CA 91342 | 2020-07-29 |
| 1528520988 | Yeun Lim | Student in an Organized Health Care Education/Training Program | 14445 Olive View Dr., Cottage H1, Attn D. Ray, Sylmar, CA 91342 | 2019-04-04 |
| 1467914317 | Sevak Hovagimyan | Pharmacist | 13677 Foothill Blvd #b, Sylmar, CA 91342 | 2019-04-01 |
| 1619455086 | Cameda Trichele Dickerson | Counselor | Phoenix House 116600 Eldridge, Lake View Terrace, CA 91342 | 2018-07-30 |
| 1407349624 | Joseph Sungkon Choi | Acupuncturist | 10274 Foothill Blvd, Sylmar, CA 91342 | 2018-06-12 |
| 1780194522 | Joe Anthony Cardenas | Specialist/Technologist | 15450 Roxford Street, Sylmar, CA 91342 | 2017-10-06 |
| 1336668466 | Juan Hernandez | Chiropractor | 13950 Foothill Blvd Apt 108, Sylmar, CA 91342 | 2017-09-09 |
| 1891213492 | Richard Ignacio Martinez | Nurse Practitioner | 14987 Oro Grande St., Sylmar, CA 91342 | 2017-09-03 |
| 1104349497 | Vanessa Gamboa | Social Worker | 13145 Bromont Ave., 14, Sylmar, CA 91342 | 2017-07-19 |
| 1982138368 | Christina Guest | Psychiatry & Neurology | Olive View Medical Center, 14445 Olive View Drive, Sylmar, CA 91342 | 2017-04-12 |
| Find all providers in zip 91342 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033231717 | Maternity House | Substance Abuse Rehabilitation Facility | 10300 Kurt St, Lake View Terrace, CA 91342-6933 | 2007-04-04 |
| 1649573148 | Kathleen E Randall | Substance Abuse Rehabilitation Facility | 11600 Eldridge Ave, Lake View Terrace, CA 91342-6506 | 2010-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497359 | California Care Detox & Treatment | Substance Abuse Rehabilitation Facility | 25542 Dana Mesa Dr, San Juan Capistrano, CA 92675-4311 | 2020-11-02 |
| 1952900797 | A Sacred Path | Substance Abuse Rehabilitation Facility | 5671 Spanish Flat Rd, Garden Valley, CA 95633 | 2020-10-22 |
| 1467051672 | Spearhead Health Centers, LLC. | Substance Abuse Rehabilitation Facility | 11704 Wilshire Blvd Ste 226, Los Angeles, CA 90025-1504 | 2020-10-19 |
| 1073111613 | A Place To Heal | Substance Abuse Rehabilitation Facility | 14540 Hamlin St Ste H, Van Nuys, CA 91411-4153 | 2020-10-15 |
| 1871191569 | Old Oak Ranch Recovery Center | Substance Abuse Rehabilitation Facility | 19401 Susan Way, Sonora, CA 95370-9266 | 2020-10-14 |
| 1962009845 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 9952 Grandview Dr, La Mesa, CA 91941-6874 | 2020-10-05 |
| 1376140384 | Magic House Recovery Inc | Substance Abuse Rehabilitation Facility | 1001 S Mountvale Ct, Anaheim, CA 92808-2108 | 2020-10-02 |
| 1942807060 | New Perceptions North, LLC | Substance Abuse Rehabilitation Facility | 5084 N Fruit Ave Ste 105, Fresno, CA 93711-3000 | 2020-10-01 |
| 1346857679 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 3480 Hidden Trail Dr, Jamul, CA 91935-2104 | 2020-09-30 |
| 1992312227 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 2810 Camino Del Rio S Ste 106, San Diego, CA 92108-3819 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
| City | LAKE VIEW TERRACE |
| Zip Code | 91342 |
Please comment or provide details below to improve the information on PHOENIX HOUSES OF LOS ANGELES, INC..
| 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.