CHABAD RESIDENTIAL TREATMENT CENTER (NPI# 1841429669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841429669 |
| Entity Type | Organization |
| Organization Name | CHABAD RESIDENTIAL TREATMENT CENTER |
| Practice Address |
5675 W Olympic Blvd Los Angeles CA 90036-4712 |
| Practice Telephone | 3239651365 |
| Practice Fax Number | 3239650444 |
| Mailing Telephone | 3239651365 |
| Mailing Fax Number | 3239650444 |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2016-03-31 |
| Authorized Official Name | MS. DONNA LYNN MILLER (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 3239651365 |
| Authorized Official Credential | MFT |
| Is Organization Subpart | Y |
| Parent Organization Name | CHABAD OF CALIFORNIA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 190087CN | CA | Residential Treatment Facilities |
| Street Address |
5675 W OLYMPIC BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90036-4712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215544135 | Jordan Alexander Escobar | Counselor | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2020-09-24 |
| 1437765377 | Kevin Lytvak | Counselor | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2020-09-16 |
| 1447868302 | Jay Michael Small | Counselor | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2020-07-16 |
| 1588281752 | Joshua Daniel Mulnick | Counselor | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2020-07-02 |
| 1831715242 | Kalina Noelle | Counselor | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2020-06-22 |
| 1588287684 | Shimon Dusowitz | Counselor | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2020-05-22 |
| 1174144638 | Eduardo Javier Martinez | Counselor | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2020-05-06 |
| 1164053914 | Aron Yakovlev | Counselor | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2020-01-30 |
| 1184264467 | Matthew John Stenger | Counselor | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2020-01-14 |
| 1073150231 | Joseph Casaceli Jr. | Counselor | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2019-12-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140198 | Stephanie N Carter | Dietitian, Registered | 460 Burnside Ave, Apt 8k, Los Angeles, CA 90036 | 2020-06-26 |
| 1609492107 | Katherine Niemela | Registered Nurse | 5619 W 4th St, Suite 5, Los Angeles, CA 90036 | 2020-06-19 |
| 1508384330 | Matthew Milstein | Psychologist | 5675 West Olympic Blvd., Los Angeles, CA 90036 | 2017-08-31 |
| 1912423963 | John Allen Ostlund | Counselor | 5675 W. Olympic Blvd, Los Angeles, CA 90036 | 2017-08-21 |
| 1306376629 | Scott William Wilson | Case Manager/Care Coordinator | 1891 N. Gaffey Street Suite 219 & 221, San Pedro, CA 90036 | 2017-06-19 |
| 1205382298 | Janice Payson | Marriage & Family Therapist | 801 South Spaulding Avenue, Suite A, Los Angeles, CA 90036 | 2016-08-30 |
| 1134577281 | Parul A Desai | Registered Nurse | 5800 Wilshire Blvd, Los Angeles, CA 90036 | 2016-05-31 |
| 1477914604 | Sarah Frank Jarvis | Marriage & Family Therapist | 7421 Beverly Blvd Ste 2, Los Angeles, CA 90036 | 2016-03-16 |
| 1558747162 | Paul Oberon, Psy.d, Inc. | Community/Behavioral Health | 7421 Beverly Blvd., #10, Los Angeles, CA 90036 | 2015-08-05 |
| 1235543117 | Benjamin Maixner | Behavioral Analyst | 441 1/2 N Curson Ave, Los Angeles, CA 90036 | 2014-06-18 |
| Find all providers in zip 90036 | ||||
| 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 |
|---|---|---|---|---|
| 1467051672 | Spearhead Health Centers, LLC. | Substance Abuse Rehabilitation Facility | 11704 Wilshire Blvd Ste 226, Los Angeles, CA 90025-1504 | 2020-10-19 |
| 1396354577 | First Step Forward, Inc | Substance Abuse Rehabilitation Facility | 7523 S Western Ave, Los Angeles, CA 90047-2430 | 2020-07-23 |
| 1619598208 | Conquer Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 1324 Keniston Ave, Los Angeles, CA 90019-1713 | 2020-05-05 |
| 1417595547 | Forward Recovery Solutions, LLC | Substance Abuse Rehabilitation Facility | 1428 Roxbury Dr, Los Angeles, CA 90035-2815 | 2019-12-19 |
| 1245878917 | Profound Treatment, LLC | Substance Abuse Rehabilitation Facility | 1990 Westwood Blvd Ste 305, Los Angeles, CA 90025-6596 | 2019-12-12 |
| 1245883594 | Vivian C Aranda | Substance Abuse Rehabilitation Facility | 4617 Zane St, Los Angeles, CA 90032-2039 | 2019-07-16 |
| 1770141764 | 310 Recovery | Substance Abuse Rehabilitation Facility | 1741 Hauser Blvd, Los Angeles, CA 90019-5111 | 2019-06-04 |
| 1689132284 | Mama and Papa Bear's Innovations, Inc | Substance Abuse Rehabilitation Facility | 5324 Fountain Ave, Los Angeles, CA 90029-1005 | 2019-03-04 |
| 1053884775 | Melrose Recovery, LLC. | Substance Abuse Rehabilitation Facility | 1253 N Commonwealth Ave, Los Angeles, CA 90029 | 2019-01-04 |
| 1669941811 | Cnv Detox Inc. | Substance Abuse Rehabilitation Facility | 5919 W 74th St, Los Angeles, CA 90045-1601 | 2018-11-16 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90036 |
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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.