EXODUS RECOVERY INC (NPI# 1114171642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114171642 |
| Entity Type | Organization |
| Organization Name | EXODUS RECOVERY INC |
| Other Organization Name | EXODUS MENTAL HEALTH WALK-IN CTR - ESCONDIDO |
| Practice Address |
1520 S Escondido Blvd Escondido CA 92025-6017 |
| Mailing Address |
9808 Venice Blvd Ste 700 Culver City CA 90232-6824 |
| Practice Telephone | 7607461146 |
| Practice Fax Number | 7607967758 |
| Mailing Telephone | 3109453350 |
| Mailing Fax Number | 3108407023 |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2013-10-30 |
| Authorized Official Name | LEEANN SKOROHOD (SR VP, OPERATIONS) |
| Authorized Official Telephone | 3109453350 |
| Authorized Official Credential | CHC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 37LC | 05 |
| Other Name | Type Code |
|---|---|
| Exodus Mental Health Walk-In Ctr - Escondido | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700311073 | Exodus Recovery Inc | Community/Behavioral Health | 1902 Marengo St Ste 109 110, Los Angeles, CA 90033-1312 | 2017-04-25 |
| 1770623241 | Exodus Recovery Inc | Community/Behavioral Health | 10811 Washington Blvd Ste 300, Culver City, CA 90232-3619 | 2007-02-07 |
| 1962063123 | Exodus Recovery Inc | Community/Behavioral Health | 1902 Marengo St Ste 107, Los Angeles, CA 90033-1378 | 2019-06-27 |
| 1972919850 | Exodus Recovery Inc | Community/Behavioral Health | 2101 Courage Dr, Fairfield, CA 94533-6717 | 2014-07-11 |
| 1205254950 | Exodus Recovery Inc | Community/Behavioral Health | 9808 Venice Blvd Ste 700, Culver City, CA 90232-6824 | 2014-03-31 |
| 1386072304 | Exodus Recovery Inc | Community/Behavioral Health | 9808 Venice Blvd, Ste 300 and Patio, Culver City, CA 90232-2750 | 2013-10-30 |
| 1437360195 | Exodus Recovery Inc | Community/Behavioral Health | 923 S Catalina Ave, Redondo Beach, CA 90277-4718 | 2007-05-24 |
| 1245441906 | Exodus Recovery Inc | Community/Behavioral Health | 8401 S Vermont Ave, Los Angeles, CA 90044-3423 | 2007-05-24 |
| Street Address |
1520 S ESCONDIDO BLVD |
| City | ESCONDIDO |
| State | CA |
| Zip Code | 92025-6017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417143207 | Micheal Weuste | Social Worker | 1520 S Escondido Blvd, Escondido, CA 92025-6017 | 2007-09-14 |
| 1235600545 | Exodus Recovery, Inc. | Community/Behavioral Health | 1520 S Escondido Blvd, Escondido, CA 92025-6017 | 2018-12-12 |
| 1124479415 | Patrick Casao Jr. | Counselor | 1520 S Escondido Blvd, Escondido, CA 92025-6017 | 2016-06-28 |
| 1841615085 | Jenna Farnsworth | Social Worker | 1520 S Escondido Blvd, Escondido, CA 92025-6017 | 2014-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962001230 | Tanya Geanna Macleod | Peer Specialist | 474 West Vermont Ave., Ste., 101, Escondido, CA 92025 | 2020-10-19 |
| 1801449640 | Jennifer Marsh | Marriage & Family Therapist | 403 N Escondido Blvd #533, Escondido, CA 92025 | 2019-07-21 |
| 1093281644 | Lucy Breen | Peer Specialist | 474 Weest Vermont Ave #104, Escondido, CA 92025 | 2018-10-22 |
| 1457834665 | Daniel & Max | Optometrist | 730 N Center City Parkway, Building A-1, Suite 101, Escondido, CA 92025 | 2018-09-13 |
| 1477033272 | Hyoshin Kwak | Acupuncturist | 106 S. Grape St, Suite 10, Escondido, CA 92025 | 2018-08-21 |
| 1467948877 | Irma P Garcia | Counselor | 337 West Mission Ave, Escondido, CA 92025 | 2018-07-09 |
| 1295235380 | Anna M. Rainville | Marriage & Family Therapist | 11701 San Pasqual Valley Rd, Escondido, CA 92025 | 2018-02-15 |
| 1689187049 | Monica Pino | Occupational Therapist | 469 E Grand Avenue, Escondido, CA 92025 | 2017-11-08 |
| 1427569581 | Mtk Primary Care Medical Group | Specialist | 1835a S Centre City Pkwy Ste 459, Escondido, CA 92025 | 2017-10-17 |
| 1619490349 | Elizabeth Sanchez Arvizu | Student in an Organized Health Care Education/Training Program | 490 N. Grape Stret, Escondido, CA 92025 | 2017-07-25 |
| Find all providers in zip 92025 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245895176 | Karina D Ibarra | Community/Behavioral Health | 1050 Rock Springs Rd Unit 219, Escondido, CA 92026-2438 | 2019-05-06 |
| 1831620871 | Mental Health Systems, Inc. | Community/Behavioral Health | 410 Hidden Trails Rd, Escondido, CA 92027-5333 | 2017-03-22 |
| 1588936074 | Key To Behavior, LLC | Community/Behavioral Health | 3144 Beven Dr, Escondido, CA 92027-6229 | 2012-01-31 |
| 1891906400 | St. Clare's Home | Community/Behavioral Health | 2091 E Valley Pkwy, Escondido, CA 92027-2743 | 2007-05-25 |
| 1174666010 | Mental Health Systems, Inc. | Community/Behavioral Health | 474 W Vermont Ave Ste 103, Escondido, CA 92025-6584 | 2007-02-14 |
| 1265074611 | Interfaith Community Services | Community/Behavioral Health | 550 W Washington Ave, Escondido, CA 92025-1643 | 2019-10-16 |
| 1932767381 | Interfaith Community Services | Community/Behavioral Health | 250 N Ash St, Escondido, CA 92027-3026 | 2019-05-31 |
| 1235600545 | Exodus Recovery, Inc. | Community/Behavioral Health | 1520 S Escondido Blvd, Escondido, CA 92025-6017 | 2018-12-12 |
| 1811472954 | Sunshine Counseling LLC | Community/Behavioral Health | 810 E Grand Ave, Escondido, CA 92025-3402 | 2018-09-25 |
| 1659895340 | Community Research Foundation Inc | Community/Behavioral Health | 337 W Mission Ave, Escondido, CA 92025-1729 | 2017-08-03 |
| Find all providers in ESCONDIDO | ||||
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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.