EXODUS RECOVERY, INC. (NPI# 1942665484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942665484 |
| Entity Type | Organization |
| Organization Name | EXODUS RECOVERY, INC. |
| Other Organization Name | EXODUS PHF FRESNO |
| Practice Address |
4411 E Kings Canyon Rd Fresno CA 93702-3604 |
| Mailing Address |
9808 Venice Blvd Ste 700 Culver City CA 90232-2732 |
| Practice Telephone | 5594535199 |
| Mailing Telephone | 3109453350 |
| Mailing Fax Number | 3108407023 |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2015-12-29 |
| Authorized Official Name | LEEANN SKOROHOD (SR VP OPERATIONS) |
| Authorized Official Telephone | 3109453350 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283Q00000X | Psychiatric Hospital | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FACILITY NUMBER | P-042 | 01 |
| Other Name | Type Code |
|---|---|
| Exodus PHF Fresno | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184272395 | Exodus Recovery, Inc. | Community/Behavioral Health | 550 W Vista Way Ste 204, Vista, CA 92083-5736 | 2019-08-30 |
| 1124596291 | Exodus Recovery, Inc. | Community/Behavioral Health | 550 W Vista Way Ste 109, Vista, CA 92083-5707 | 2018-11-07 |
| 1104307164 | Exodus Recovery, Inc. | Community/Behavioral Health | 1000 W Carson St Rm 2022, Bldg 2 South, Torrance, CA 90502-2004 | 2018-08-27 |
| 1740771559 | Exodus Recovery, Inc. | Community/Behavioral Health | 12021 S Wilmington Ave Fl 2, Ic1-ic7, Los Angeles, CA 90059-3019 | 2018-05-29 |
| 1184169815 | Exodus Recovery, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3754-56 Overland Ave, Los Angeles, CA 90034-6312 | 2017-01-04 |
| 1356711436 | Exodus Recovery, Inc. | Community/Behavioral Health | 8513 S Vermont Ave, Los Angeles, CA 90044-3425 | 2015-10-01 |
| 1083943005 | Exodus Recovery, Inc. | Community/Behavioral Health | 4308 30th St, Suite A, San Diego, CA 92104-1314 | 2009-12-22 |
| 1053598979 | Exodus Recovery, Inc. | Community/Behavioral Health | 524 W Vista Way # 55, Vista, CA 92083-5704 | 2008-01-22 |
| 1437704806 | Exodus Recovery, Inc. | Community/Behavioral Health | 11905 S Central Ave Ste 303, Los Angeles, CA 90059-2897 | 2019-08-02 |
| 1235600545 | Exodus Recovery, Inc. | Community/Behavioral Health | 1520 S Escondido Blvd, Escondido, CA 92025-6017 | 2018-12-12 |
| Street Address |
4411 E KINGS CANYON RD |
| City | FRESNO |
| State | CA |
| Zip Code | 93702-3604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649275132 | Marianne Elena Tur | Nurse Practitioner | 4411 E Kings Canyon Rd, Fresno, CA 93702 | 2005-06-20 |
| 1992304653 | Ronda Denise Lincoln | Registered Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-10-22 |
| 1871100248 | Tanveer Hans | Licensed Psychiatric Technician | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-09-29 |
| 1568079192 | Samantha Hagerman | Registered Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-09-28 |
| 1952917130 | Aly Kelly Ly | Registered Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-09-22 |
| 1144848615 | Jennifer Salinas | Licensed Vocational Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-07-10 |
| 1144848052 | Amarvir Khroud | Registered Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-07-07 |
| 1841818994 | Maria Lourdes Aguilar | Licensed Vocational Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-07-06 |
| 1366069577 | Ulysses Ruvalcaba | Licensed Psychiatric Technician | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-07-03 |
| 1013532316 | Nada Moua | Registered Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730644543 | Brandy Eugena Dickey | Licensed Vocational Nurse | 496 S. Barton St., Fresno, CA 93702 | 2019-02-06 |
| 1205308269 | Kelly Ramirez | Counselor | 496 S. Barton St, Fresno, CA 93702 | 2018-12-31 |
| 1518437995 | Kimberlin Ann Klein | Licensed Vocational Nurse | 4411 E Kings Canyon Rd #319, Fresno, CA 93702 | 2018-11-28 |
| 1932677317 | Simone Danielle Cato | Counselor | 496 S Barton St, Fresno, CA 93702 | 2018-11-05 |
| 1558879841 | Mekdes Elizabeth Yilma | Marriage & Family Therapist | 4144 E. Kings Canyon Rd., Fresno, CA 93702 | 2018-01-20 |
| 1831647874 | Rick Foster | Registered Nurse | 441 East Kings Canyon Ave, Fresno, CA 93702 | 2016-09-20 |
| 1770935140 | Diana L. Eaglin | Registered Nurse | 4409 E. Inyo St., Modular A, Fresno, CA 93702 | 2016-07-08 |
| 1700257243 | Elizabeth Lee | Registered Nurse | 4411 E.kings Canyon Rd, Fresno, CA 93702 | 2015-10-09 |
| 1548657299 | Brandi Lynn Rieux | Counselor | 496 S. Barton Ave, Fresno, CA 93702 | 2015-04-21 |
| 1891069548 | Tamara Taylor | Case Manager/Care Coordinator | 890 S. Tenth Street, Fresno, CA 93702 | 2012-02-28 |
| Find all providers in zip 93702 | ||||
| Taxonomy Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932603990 | Central Star Behavioral Health, Inc. | Psychiatric Hospital | 496 South Barton Ave, Fresno, CA 93750-0001 | 2018-03-22 |
| 1982071072 | Isaac Garibay | Psychiatric Hospital | 5898 E Madison Ave, Fresno, CA 93727-3515 | 2015-08-25 |
| 1427461136 | Central Star Behavioral Health, Inc. | Psychiatric Hospital | 4411 East Kings Canyon Road, Bldg. 319, Fresno, CA 93702-3604 | 2014-06-10 |
| 1124308275 | Michael E Debakey Vamc | Psychiatric Hospital | 4030 Longway Estates Ct, Fresno, TX 77545-8645 | 2011-08-22 |
| 1679602080 | Fresno County Community Behavioral Health Center | Psychiatric Hospital | 7171 N Cedar Ave, Fresno, CA 93720-3311 | 2007-03-02 |
| 1093816472 | Michael E. Debakey Va Hospital | Psychiatric Hospital | 4038 Teal Run Place Court, Fresno, TX 77545 | 2006-09-26 |
| 1891091286 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2011-02-01 |
| 1457428856 | County of Fresno Dept. of Behavioral Health | Psychiatric Hospital | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740892017 | Avamed Inc. | Psychiatric Hospital | 12955 Riverside Dr Apt 204, Sherman Oaks, CA 91423-2202 | 2020-08-18 |
| 1437769957 | North Valley Behavioral Health, LLC | Psychiatric Hospital | 1253 Stabler Lane, Yuba City, CA 95993 | 2020-08-10 |
| 1811549504 | Sacramento Behavioral Healthcare Hospital, LLC | Psychiatric Hospital | 1400 Expo Pkwy, Sacramento, CA 95815-4230 | 2019-07-12 |
| 1639601933 | Restpadd Health Corp | Psychiatric Hospital | 925 Walnut St, Red Bluff, CA 96080-3707 | 2017-03-28 |
| 1790223790 | Adrian Zamora | Psychiatric Hospital | 1569 Michael Place, Porterville, CA 93257 | 2017-02-09 |
| 1558812404 | Sonnia A. Ahinasi | Psychiatric Hospital | 4192 Via Napoli, Montclair, CA 91763-4750 | 2016-10-16 |
| 1316399660 | Itzel Lopez | Psychiatric Hospital | 1869 Lombard St, San Francisco, CA 94123-2909 | 2016-07-11 |
| 1770931032 | Ruby Lorraine Summus | Psychiatric Hospital | 4111 Jonathon St, Oceanside, CA 92056-4217 | 2016-05-27 |
| 1760841126 | County of Los Angeles | Psychiatric Hospital | 5800 South St Apt 163, Lakewood, CA 90713-1331 | 2016-02-15 |
| 1780081158 | Sharon Medina | Psychiatric Hospital | 5613 Mariolyn Ct, Elk Grove, CA 95757-1626 | 2014-12-01 |
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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.