EMQ HOLLYGROVE (NPI# 1275739401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275739401 |
| Entity Type | Organization |
| Organization Name | EMQ HOLLYGROVE |
| Practice Address |
815 N El Centro Ave Los Angeles CA 90038-3805 |
| Mailing Address |
950 S Westmoreland Ave Apt. 202 Los Angeles CA 90006-5669 |
| Practice Telephone | 3234632119 |
| Mailing Telephone | 2132528577 |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. DERIC MARTEZ HORTON (DAY REHABILITATION SPECIALIST) |
| Authorized Official Telephone | 3234632119 |
| Authorized Official Credential | BA MHRS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 322D00000X | CA | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003003542 | Emq Hollygrove | Community/Behavioral Health | 815 N El Centro Ave, Los Angeles, CA 90038-3805 | 2007-09-28 |
| Street Address |
815 N EL CENTRO AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90038-3805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922082700 | Heidi Sulman-smith | Psychiatry & Neurology | 815 N El Centro Ave, Los Angeles, CA 90038-3805 | 2005-12-05 |
| 1346878832 | Angelica Hernandez Manrique | Student in an Organized Health Care Education/Training Program | 815 N El Centro Ave, Los Angeles, CA 90038-3805 | 2020-03-30 |
| 1417585415 | Mariela Lourdes Caceres | Student in an Organized Health Care Education/Training Program | 815 N El Centro Ave, Los Angeles, CA 90038-3805 | 2020-03-27 |
| 1831725449 | Sally Chung | Student in an Organized Health Care Education/Training Program | 815 N El Centro Ave, Los Angeles, CA 90038-3805 | 2020-03-14 |
| 1073148904 | Patsy Karinna Rodriguez | Student in an Organized Health Care Education/Training Program | 815 N El Centro Ave, Los Angeles, CA 90038-3805 | 2020-03-11 |
| 1083245666 | Diane Pimentel Vera | Case Manager/Care Coordinator | 815 N El Centro Ave, Los Angeles, CA 90038-3805 | 2020-01-31 |
| 1366090631 | Hector Lomeli | Case Manager/Care Coordinator | 815 N El Centro Ave, Los Angeles, CA 90038-3805 | 2019-08-29 |
| 1740844380 | Melody Villar | Student in an Organized Health Care Education/Training Program | 815 N El Centro Ave, Los Angeles, CA 90038-3805 | 2019-04-29 |
| 1992268858 | Sergio Ortiz | Student in an Organized Health Care Education/Training Program | 815 N El Centro Ave, Los Angeles, CA 90038-3805 | 2019-04-08 |
| 1407319353 | Taeana Mechalle Stephens | Student in an Organized Health Care Education/Training Program | 815 N El Centro Ave, Los Angeles, CA 90038-3805 | 2019-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114568698 | Kaiser Foundation Health Plan Inc | Pharmacy | 7007 Romaine St, Los Angeles, CA 90038 | 2019-10-04 |
| 1134685613 | National Vision Inc | Technician/Technologist | 5818 Santa Monica Boulevard, Los Angeles, CA 90038 | 2019-02-20 |
| 1023530482 | Christopher Michael Colon | Case Manager/Care Coordinator | 1224 N Vine Street, Los Angeles, CA 90038 | 2017-07-07 |
| 1841736477 | Randall Smith | Counselor | 7000 Romaine, 207-208, La, CA 90038 | 2017-01-06 |
| 1780050278 | Craig V. Smith, M.d., A Professional Medical Corporation | Internal Medicine | 6711 Melrose Ave., Los Angeles, CA 90038 | 2015-08-19 |
| 1033585534 | M2 Recovery, Inc. | Clinic/Center | 6715 Melrose Ave., Los Angeles, CA 90038 | 2015-08-19 |
| 1457760522 | Lital Shvarts | Psychologist | 6311 Romaine St Ste 7329, Los Angeles, CA 90038 | 2014-08-04 |
| 1144658071 | Aaron Niemi | Acupuncturist | 1011 North Cole Ave, Los Angeles, CA 90038 | 2013-11-01 |
| 1013351139 | Suren Vardanyan | Non-emergency Medical Transport (VAN) | 1208 N Gower St, #201, Los Angeles, CA 90038 | 2013-04-19 |
| 1093912966 | Tina Robinson | Registered Nurse | 1224 Vine St., Los Angeles, CA 90038 | 2007-07-02 |
| Find all providers in zip 90038 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457863706 | The Dream Catcher Foundation, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1537 W 49th St, Los Angeles, CA 90062 | 2017-10-26 |
| 1083125603 | The Dream Catcher Foundation, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 3601 2nd Ave, Los Angeles, CA 90018 | 2017-10-23 |
| 1710498332 | The Dream Catcher Foundation, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 4173 2nd Ave, Los Angeles, CA 90008 | 2017-10-23 |
| 1639680259 | The Dream Catcher Foundation, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1762 W 42nd St, Los Angeles, CA 90062 | 2017-10-23 |
| 1780129486 | Los Angeles Youth Network | Residential Treatment Facility, Emotionally Disturbed Children | 2471 N Beachwood Dr, Los Angeles, CA 90068-3004 | 2017-01-04 |
| 1245773290 | Deliann-lucile Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1564 W 36th Pl, Los Angeles, CA 90018-4503 | 2016-11-23 |
| 1982147922 | Deliann-lucile Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 2122 W 107th St, Los Angeles, CA 90047-4305 | 2016-11-23 |
| 1306395454 | Deliann-lucile | Residential Treatment Facility, Emotionally Disturbed Children | 5800 Hannum Ave Ste 230, Los Angeles, CA 90230-6553 | 2016-09-30 |
| 1619400330 | Hamburger Home | Residential Treatment Facility, Emotionally Disturbed Children | 1701 Camino Palmero St, Los Angeles, CA 90046-2902 | 2017-04-10 |
| 1922548932 | Deliann-lucile Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1564 W 36th Pl, Los Angeles, CA 90018-4503 | 2017-02-24 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90038 |
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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.