DEDICATO TREATMENT CENTER INC (NPI# 1013415215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1013415215 |
Entity Type | Organization |
Organization Name | DEDICATO TREATMENT CENTER INC |
Other Organization Name | DEDICATO TREATMENT CENTER-OUTPATIENT SERVICE |
Practice Address |
133 N Altadena Dr Ste 430 Pasadena CA 91107-7344 |
Mailing Address |
22 W Carter Ave Sierra Madre CA 91024-1219 |
Practice Telephone | 6264608292 |
Practice Fax Number | 6269210214 |
Mailing Telephone | 6269210113 |
Enumeration Date | 2018-01-23 |
Last Update Date | 2018-11-08 |
Authorized Official Name | DR. DR KEITH LAMONT MARSHALL (CEO & CLINICAL DIRECTOR) |
Authorized Official Telephone | 6266448857 |
Authorized Official Credential | PSY.D, MA, LAADC |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
Other Name | Type Code |
---|---|
Dedicato Treatment Center Inc. | Doing Business As Name - Organization |
Dedicato Treatment Center-Outpatient Service | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417313214 | Dedicato Treatment Center Inc | Substance Abuse Rehabilitation Facility | 22 W Carter Ave, Sierra Madre, CA 91024-1219 | 2016-01-08 |
Street Address |
133 N ALTADENA DR STE 430 |
City | PASADENA |
State | CA |
Zip Code | 91107-7344 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801412002 | Kwasi Nkansa | Physical Medicine & Rehabilitation | 2585 East Washington Blvd, Pasadena, CA 91107 | 2020-06-23 |
1609402742 | H & S Hospice Care Inc | Hospice Care, Community Based | 2525 E Colordo Blvd Suite 109, Pasadena, CA 91107 | 2020-03-20 |
1013557115 | Cindy Phun | Pharmacist | 3383 E Foothill Blvd, Pasadena, CA 91107 | 2020-01-07 |
1184185548 | Preferred Home Health Services | Home Health | 40 N Atlandena Dr Suite 219, Pasadena, CA 91107 | 2019-03-28 |
1861973729 | Julia E Underwood | Doula | 2335-115 E. Colorado Blvd #339, Pasadena, CA 91107 | 2018-08-28 |
1982183166 | Melissa Castillo | Counselor | 26 S Kinneloa Ave, Pasadena, CA 91107 | 2018-08-09 |
1083109904 | Lourice Boutros | Optometrist | 3235 E Colorado Blvd Ste 101, Pasadena, CA 91107 | 2018-06-22 |
1902313026 | Cecily Brogdon | Marriage & Family Therapist | 2115 Lambert Drive, Pasadena, CA 91107 | 2018-01-10 |
1790204915 | Vanessa Nicole Contreras | Licensed Vocational Nurse | 36 S. Kinneiloa Ave., Pasadena, CA 91107 | 2017-09-19 |
1730614397 | Rita Mason | Behavioral Analyst | 890 S Rosemead Blvd, Ste 45, Pasadena, CA 91107 | 2017-04-20 |
Find all providers in zip 91107 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356975593 | Robbie Davis | Counselor | 1710 Strawberry Rd Ste 300, Pasadena, TX 77502-2649 | 2020-02-26 |
1730649922 | Barrett Arthur Tollenger | Counselor | 2825 Mountain Road, Suite 204, Pasadena, MD 21122 | 2019-03-22 |
1689144271 | Cathy Haigis | Counselor | 2528 Mountain Rd.7204, Pasadena, MD 21122-7204 | 2018-11-27 |
1093284382 | Jack Lee Johnson II | Counselor | 1680 North Fair Oaks, Pasadena, CA 91104 | 2018-11-16 |
1013407071 | Sean Patrick Comingore | Counselor | 1680 N. Fair Oaks Ave., Pasadena, CA 91103 | 2018-05-15 |
1639678287 | Sean C Velazco | Counselor | 1245 E. Walnut St., Pasadena, CA 91106 | 2018-02-09 |
1306366604 | Joseph Anthony Zepeda | Counselor | 1680 N. Fair Oaks Avenue, Pasadena, CA 91103 | 2017-06-27 |
1922528769 | Calvin Hayes | Counselor | 135 W Washington Blvd, Pasadena, CA 91103-2563 | 2017-06-22 |
1518406545 | Kevin Cross | Counselor | 25 El Nido Ave Apt 5, Pasadena, CA 91107-4448 | 2017-02-23 |
1306385133 | Alan Ray Brown | Counselor | 225 Grandview St, Pasadena, CA 91104-2114 | 2017-02-13 |
Find all providers in PASADENA |
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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.