DUAL DIAGNOSIS ASSESSMENT AND TREATMENT CENTER (NPI# 1770802043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770802043 |
| Entity Type | Organization |
| Organization Name | DUAL DIAGNOSIS ASSESSMENT AND TREATMENT CENTER |
| Practice Address |
441 W Hillcrest Blvd Inglewood CA 90301-2521 |
| Mailing Address |
19300 Rinaldi St Ste. 8270 Northridge CA 91326-1651 |
| Practice Telephone | 8884175163 |
| Practice Fax Number | 5623435820 |
| Mailing Telephone | 8884175163 |
| Mailing Fax Number | 5623435820 |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2011-01-05 |
| Authorized Official Name | EDNA MILLER (DIRECTOR) |
| Authorized Official Telephone | 8884175163 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL | CMM71096F | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457398539 | Dual Diagnosis Assessment and Treatment Center | Clinic/Center | 3545 Wilshire Blvd, Los Angeles, CA 90010-2388 | 2006-05-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DUAL DIAGNOSIS ASSESSMENT AND TREATMENT CENTER INC. | 19300 Rinaldi St #8270, Northridge, CA 91326-1651 |
| Street Address |
441 W HILLCREST BLVD |
| City | INGLEWOOD |
| State | CA |
| Zip Code | 90301-2521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023229028 | Development Specialty Projects, Inc. | Clinic/Center | 441 W Hillcrest Blvd, Inglewood, CA 90301-2521 | 2007-05-24 |
| 1902102304 | R.i.g.h.t. Program | Community/Behavioral Health | 441 W Hillcrest Blvd, Inglewood, CA 90301-2521 | 2011-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548897945 | Genevieve V. Angel | Registered Nurse | 555 East Hardy Street, Director of Cm Sw, Centinela Hospital Medical Center, Inglewood, CA 90301 | 2020-03-25 |
| 1992338552 | Ralph Kevin Roque | Licensed Practical Nurse | 614 W Manchester Blvd, Inglewood, Ca 90301, 104, Inglewood, CA 90301 | 2020-02-21 |
| 1043841562 | Evelyn Jones | Social Worker | 555 E. Hardy Street, Inglewood, Ca, CA 90301 | 2020-02-03 |
| 1447896444 | Coral Dabarera Edelson | Dietitian, Registered | 110 North La Brea Ave, Inglewood, CA 90301 | 2019-11-25 |
| 1821642125 | Jennifer Robert Umoh | Student in an Organized Health Care Education/Training Program | 412 E Florence Avenue, Inglewood, CA 90301 | 2019-07-25 |
| 1821567751 | Esther Voltaire | Behavior Technician | 619 E Arbor Vitae St, Inglewood, CA 90301 | 2018-11-21 |
| 1902372832 | Pool Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 323 North Prairie Ave, Suite 200, Ingelwood, CA 90301 | 2018-10-18 |
| 1174003594 | Xelnt Healthcare Inc. | Clinic/Center | 501 E Hardy St Ste 425, Inglewood, CA 90301 | 2018-08-15 |
| 1710409321 | Rae Shelston Mcintosh | Licensed Vocational Nurse | 1007 Myrth Ave, Inglewood, CA 90301 | 2017-07-14 |
| 1477093789 | Lewis E Logan II | Counselor | 332 N. Prairie Ave., Suite 417, Inglewood, CA 90301 | 2017-03-06 |
| Find all providers in zip 90301 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831419886 | Dual Diagnosis Assessment and Treatment Center, Inc. | Clinic/Center | 151 North Grevillea Avenue, Inglewood, CA 90301 | 2010-06-01 |
| 1396064671 | Dual Diagnosis Assessment and Treatment Center, Inc. | Clinic/Center | 9330 S 8th Ave, Inglewood, CA 90305-2914 | 2010-05-25 |
| 1841519121 | Dual Diagnosis Assessment and Treatment Center, Inc. | Clinic/Center | 10500 Yukon Ave, Inglewood, CA 90303-2003 | 2010-05-25 |
| 1679892947 | Dual Diagnosis Assessment and Treatment Center, Inc. | Clinic/Center | 5354 W 64th St, Inglewood, CA 90302-1042 | 2010-05-25 |
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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.