EDT SERVICES LLC (NPI# 1881735587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881735587 |
| Entity Type | Organization |
| Organization Name | EDT SERVICES LLC |
| Other Organization Name | NEW DAWN TREATMENT CENTERS - VILLA LADERA |
| Practice Address |
6380 Wells Ave Loomis CA 95650-9302 |
| Mailing Address |
11230 Gold Express Dr # 310-353 Gold River CA 95670-4484 |
| Practice Telephone | 9167841149 |
| Practice Fax Number | 8663367276 |
| Mailing Telephone | 9167841149 |
| Mailing Fax Number | 8663567299 |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2019-07-29 |
| Authorized Official Name | MR. ROSS STUART MORTON (CEO) |
| Authorized Official Telephone | 9167841149 |
| Authorized Official Credential | J.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | EDT SERVICES LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities | ||
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Marin Vista Health and Wellness Center | Doing Business As Name - Organization |
| New Dawn Treatment Centers - Villa Ladera | Doing Business As Name - Organization |
| Street Address |
6380 WELLS AVE |
| City | LOOMIS |
| State | CA |
| Zip Code | 95650-9302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629252622 | Kevin Fleming Chiropractic, Inc | Chiropractor | 3621 Taylor Road, Suite A, Loomis, CA 95650 | 2007-12-27 |
| 1316133754 | Leslie Ann Hirschaut | Psychiatry & Neurology | 2499 Humphrey Rd, Loomis, CA 95650 | 2007-09-19 |
| 1356545693 | William J Ryland | Counselor | 5980 Webb Street, Loomis, CA 95650 | 2007-06-12 |
| 1316163462 | Michael Ratliff | Non-emergency Medical Transport (VAN) | 5900 King Rd Ste 209, Loomis, CA 95650 | 2007-04-17 |
| 1366573289 | Peter S. Klem, Od | Optometrist | 3493 Taylor Rd, Loomis, CA 95650 | 2007-03-09 |
| 1649260217 | Takemoto Drug Co | Pharmacy | 3685 Taylor Rd, Loomis, CA 95650 | 2005-10-25 |
| 1245725464 | Koinonia Foster Homes, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3725 Taylor Rd, Loomis, CA 95650 | 2018-06-29 |
| 1538511852 | Allison Lensing | Community Health Worker | 3725 Taylor Rd, Loomis, CA 95650 | 2016-07-11 |
| 1851595938 | Donald Richmond | Counselor | 5980 Webb Street, Loomis, CA 95650 | 2007-06-13 |
| 1770787020 | Koinonia Foster Homes, Inc | Clinic/Center | 5980 Webb Street, Loomis, CA 95650 | 2007-06-12 |
| Find all providers in zip 95650 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
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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.