NOVO DETOX NPI 1194242966

NPI Information

NPI: 1194242966
Provider Name: NOVO DETOX
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
11346 THURSTON PL
LOS ANGELES, CA
ZIP 90049
Phone: (602) 430-7543
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NOVO DETOX is a substance abuse rehabilitation facility in Los Angeles, CA. The provider is 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. NOVO DETOX NPI is 1194242966. The provider is registered as an organization entity type.

The provider's business location address is:

11346 THURSTON PL
LOS ANGELES, CA
ZIP 90049-429
Phone: (602) 430-7543

The provider's authorized official is Matthew Ziering .
The authorized official title is Cfo and has the following contact phone number (310) 663-8890.

The enumeration date for this NPI number is 8/23/2017 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Primary
1	251S00000X	Community/Behavioral Health	No
2	276400000X	Rehabilitation, Substance Use Disorder Unit	No
3	320800000X	Community Based Residential Treatment Facility, Mental Illness	No
4	324500000X	Substance Abuse Rehabilitation Facility	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	190982AP	OTHER	CALIFORNIA	STATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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