COVENANT HOUSE CALIFORNIA (NPI# 1518169325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518169325 |
| Entity Type | Organization |
| Organization Name | COVENANT HOUSE CALIFORNIA |
| Other Organization Name | CHILDREN'S HOSPITAL LA COVENANT |
| Practice Address |
1325 N Western Ave Los Angeles CA 90027-5615 |
| Practice Telephone | 3234613131 |
| Practice Fax Number | 3239577419 |
| Mailing Telephone | 3234613131 |
| Mailing Fax Number | 3239576491 |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2017-01-30 |
| Authorized Official Name | MR. BILL BEDROSSIAN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3234613131 |
| Authorized Official Credential | MSW |
| Is Organization Subpart | Y |
| Parent Organization Name | COVENANT HOUSE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | Agencies | ||
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Children's Hospital La Covenant | Other Name - Individual/Organization |
| Street Address |
1325 N WESTERN AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90027-5615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578604534 | Myong Kim | Counselor | 1325 N Western Ave, Los Angeles, CA 90027-5615 | 2007-02-10 |
| 1558960534 | Rosetta Hunter | Case Management | 1325 N Western Ave, Los Angeles, CA 90027-5615 | 2020-10-21 |
| 1477161677 | Sonia Sanchez | Case Manager/Care Coordinator | 1325 N Western Ave, Los Angeles, CA 90027-5615 | 2020-07-14 |
| 1386268761 | Luis Antonio Diaz | Case Manager/Care Coordinator | 1325 N Western Ave, Los Angeles, CA 90027-5615 | 2020-06-02 |
| 1689297889 | Casey Steven Sbrana | Case Manager/Care Coordinator | 1325 N Western Ave, Los Angeles, CA 90027-5615 | 2020-05-21 |
| 1801419015 | Latiera Zachery | Case Manager/Care Coordinator | 1325 N Western Ave, Los Angeles, CA 90027-5615 | 2020-05-21 |
| 1417570623 | Meghan Loftin | Case Manager/Care Coordinator | 1325 N Western Ave, Los Angeles, CA 90027-5615 | 2020-05-21 |
| 1558981423 | Beverly Meza | Case Manager/Care Coordinator | 1325 N Western Ave, Los Angeles, CA 90027-5615 | 2020-04-21 |
| 1043789951 | Christine Monaghan | Case Manager/Care Coordinator | 1325 N Western Ave, Los Angeles, CA 90027-5615 | 2018-11-20 |
| 1760957831 | Nic Nesbit | Case Manager/Care Coordinator | 1325 N Western Ave, Los Angeles, CA 90027-5615 | 2018-10-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326653593 | Lamia Binhuwaishel | Student in an Organized Health Care Education/Training Program | 4650 Sunset Blvd, Craniofacial and Special Needs Ortho, Los Angeles, CA 90027 | 2020-09-14 |
| 1285242594 | Rocio Jimenez | Case Manager/Care Coordinator | 4650 Sunset Blvd, Mailstop #53, Los Angeles, CA 90027 | 2020-07-22 |
| 1558984799 | Integrative Endodontics, Inc | Dentist | 10850 Wilshine Blvd Ste 301, Los Angeles, CA 90027 | 2020-05-22 |
| 1104450295 | Sarayana Sercarz | Marriage & Family Therapist | 4080 Woking Way, Los Angeles, CA 90027 | 2020-02-27 |
| 1457991143 | George Michaiel | Pediatrics | 4650 Sunset Blvd., Ms #54, Los Angeles, CA 90027 | 2020-01-09 |
| 1477199297 | Molly Rose Holmes | Marriage & Family Therapist | 3901 Los Feliz Boulevard, #303, Los Angeles, CA 90027 | 2019-11-27 |
| 1588206171 | Dental Help Solutions, LLC | Dentist | 4606 Hollywood Blvd, Suite A, Los Angeles, CA 90027 | 2019-10-15 |
| 1457905986 | Carmen L Ponce | Physical Therapy Assistant | 4867 Sunset Ave, Los Angeles, CA 90027 | 2019-08-01 |
| 1447729009 | Matthew Mendoza | Respiratory Therapist, Registered | 4867 Sunset Blvd, Los Angeles, Ca, Los Angeles, CA 90027 | 2018-11-13 |
| 1659856284 | Leticia Mendez | Nurse Practitioner | 1300 N Vermont Ave 606, Los Angeles, CA 90027 | 2018-09-29 |
| Find all providers in zip 90027 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386283984 | Aptus Pacem, LLC | Community Based Residential Treatment Facility, Mental Illness | 5035 E Echo St, Los Angeles, CA 90042-3915 | 2019-12-30 |
| 1023578705 | Mindful Growth Foundation | Community Based Residential Treatment Facility, Mental Illness | 1208 W 38th St, Los Angeles, CA 90037-1106 | 2019-03-20 |
| 1114491636 | Mindful Growth Foundation | Community Based Residential Treatment Facility, Mental Illness | 3924 W Adams Blvd, Los Angeles, CA 90018-1755 | 2019-01-17 |
| 1467963256 | Special Service for Groups, Inc. | Community Based Residential Treatment Facility, Mental Illness | 2178 Firestone Blvd, Los Angeles, CA 90002 | 2017-10-19 |
| 1184169815 | Exodus Recovery, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3754-56 Overland Ave, Los Angeles, CA 90034-6312 | 2017-01-04 |
| 1205262748 | Reese's Board and Care Home | Community Based Residential Treatment Facility, Mental Illness | 11205 Monitor Ave, Los Angeles, CA 90059-1935 | 2013-09-16 |
| 1093152076 | Bridges To Recovery IIii | Community Based Residential Treatment Facility, Mental Illness | 10201 Charing Cross Rd, Los Angeles, CA 90024-1814 | 2013-05-30 |
| 1104199033 | Adrienne James | Community Based Residential Treatment Facility, Mental Illness | 3776 S Gramercy Pl, One Half, Los Angeles, CA 90018-4377 | 2012-02-23 |
| 1144593518 | Dmhlac Eob Pmrt Sa5 | Community Based Residential Treatment Facility, Mental Illness | 11303 W, Olympic Boulevard, Los Angeles, CA 90066 | 2012-02-16 |
| 1396014544 | Bridges To Recovery IIi | Community Based Residential Treatment Facility, Mental Illness | 777 Sarbonne Rd, Los Angeles, CA 90077-3320 | 2011-12-16 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90027 |
Please comment or provide details below to improve the information on COVENANT HOUSE CALIFORNIA.
| 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.