DIXON RECOVERY INSTITUTE, INC. (NPI# 1780814640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780814640 |
| Entity Type | Organization |
| Organization Name | DIXON RECOVERY INSTITUTE, INC. |
| Other Organization Name | CENTRAL HIGH SCHOOL'S SOJOURNER TRUTH CLASSROOM |
| Practice Address |
4066 W 17th St Module #1 & 2 Los Angeles CA 90019-6025 |
| Mailing Address |
4715 Crenshaw Blvd Los Angeles CA 90043-1233 |
| Practice Telephone | 3239883744 |
| Mailing Telephone | 3239883744 |
| Mailing Fax Number | 3239889672 |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2012-05-07 |
| Authorized Official Name | RONDA DIXON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3239883744 |
| Authorized Official Credential | JD |
| Is Organization Subpart | Y |
| Parent Organization Name | DIXON RECOVERY INSTITUTE, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
190622AN | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DRUG MEDI-CAL | 7336 | 01 |
| Other Name | Type Code |
|---|---|
| Central High School's Sojourner Truth Classroom | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265892079 | Dixon Recovery Institute, Inc. | Community/Behavioral Health | 1512 W Slauson Ave, Rms. 103, 202 & 210, Los Angeles, CA 90047-1230 | 2016-03-07 |
| 1013146778 | Dixon Recovery Institute, Inc. | Community/Behavioral Health | 7400 W Manchester Ave, Rms 1 & 2, Westchester, CA 90045-2322 | 2009-07-02 |
| 1548498280 | Dixon Recovery Institute, Inc. | Community/Behavioral Health | 3124 7th Avenue, Los Angeles, CA 90018-1819 | 2009-07-01 |
| 1689858672 | Dixon Recovery Institute, Inc. | Counselor | 4715 Crenshaw Blvd, 2nd Floor, Los Angeles, CA 90043-1233 | 2007-12-26 |
| 1235369745 | Dixon Recovery Institute, Inc. | Community/Behavioral Health | 325 E 111th St, Multi-purpose Room, Los Angeles, CA 90061-3003 | 2009-07-17 |
| 1104055862 | Dixon Recovery Institute, Inc. | Community/Behavioral Health | 1803 Crenshaw Blvd, Los Angeles, CA 90019-6039 | 2009-07-02 |
| 1184859548 | Dixon Recovery Institute, Inc. | Community/Behavioral Health | 325 E 111th St, Rms. 241 & 327, Los Angeles, CA 90061-3003 | 2009-05-28 |
| Street Address |
4066 W 17TH ST MODULE #1 & 2 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90019-6025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225329048 | R.i.g.h.t. Program | Community/Behavioral Health | 4066 W 17th St, Los Angeles, CA 90019-6025 | 2011-04-27 |
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| 1386299139 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 1302 South La Brea, Los Angeles, CA 90019 | 2019-08-08 |
| 1104383694 | 310 Recovery Inc. | Clinic/Center | 1723 1/2 Hauser Blvd, Los Angeles, CA 90019 | 2019-02-21 |
| 1184131328 | Sehyeong Son | Acupuncturist | 1722 Crenshaw Blvd, Los Angeles, CA 90019 | 2018-01-09 |
| 1285158154 | Vanessa A. Myrie | Social Worker | 5562 Packard St., Los Angeles, CA 90019 | 2017-08-01 |
| 1093241309 | Hamburger Home | Community/Behavioral Health | 4066 W. 17th Street, Los Angeles, CA 90019 | 2017-05-05 |
| 1639614779 | Jung Ho Kang | Acupuncturist | 903 S. Crenshaw Blvd #304a, Los Angeles, CA 90019 | 2016-12-28 |
| 1912353491 | Sung Won Lee | Acupuncturist | 4027 W. Pico Bl., Los Angeles, CA 90019 | 2016-05-13 |
| 1497188528 | Sfvcmhc | Community/Behavioral Health | 5754 San Vicente Blvd, 401, Los Angeles, CALIFORNIA 90019 | 2013-08-13 |
| 1467890160 | Denise Breheny | Lactation Consultant, Non-RN | 1053 Carmona Ave., Los Angeles, CA 90019 | 2013-06-05 |
| 1336483122 | Nancy Denise - Latten Davidson | Student in an Organized Health Care Education/Training Program | 4073-75 West Pico Blvd, Los Angeles, CA 90019 | 2012-11-16 |
| Find all providers in zip 90019 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457377 | Marian Locke | Counselor | 3901 W Adams Blvd, Los Angeles, CA 90018-1756 | 2020-11-05 |
| 1871193888 | Daniel Luna | Counselor | 811 Beacon Ave, Los Angeles, CA 90017-2113 | 2020-10-28 |
| 1962000240 | Frederick P Delafield Iv | Counselor | 679 1/2 Levering Ave, Los Angeles, CA 90024-2350 | 2020-10-09 |
| 1578179941 | Leo Vasquezawarez | Counselor | 470 E 3rd St # Ab, Los Angeles, CA 90013-1629 | 2020-09-21 |
| 1801401963 | Manuel Gambino | Counselor | 11301 Wilshire Blvd Bldg 337, Los Angeles, CA 90073-1003 | 2020-09-14 |
| 1871107219 | Frances Field | Counselor | 3739 Mentone Ave Apt 7, Los Angeles, CA 90034-6444 | 2020-09-02 |
| 1730707985 | Lucia Miguel | Counselor | 1428 W 59th St, Los Angeles, CA 90047-1209 | 2020-07-13 |
| 1821615220 | Sarah Payne | Counselor | 3217 North Eastern Ave, Los Angeles, CA 90032 | 2020-07-01 |
| 1376168070 | Mercedes Elkoff | Counselor | 1745 Warnall Ave, Los Angeles, CA 90024-5358 | 2020-06-09 |
| 1508481201 | Jeanine Ingram | Counselor | 3815 Lockland Dr, Los Angeles, CA 90008-3533 | 2020-06-09 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90019 |
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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.