Organization
EXODUS FOUNDATION FOR RECOVERY
Active
Other names
Exodus MLK UCC
Organization subpart
No
Provider details
NPI number
Authorized official
LEEANN SKOROHOD (SR VP OPERATIONS)
(310) 945-3350
Entity
Organization
Contact information
Practice address
12021 S WILMINGTON AVE, LOS ANGELES, CA 90059-3019
(562) 295-4617
(562) 295-4665
Mailing address
9808 VENICE BLVD, SUITE 700, CULVER CITY, CA 90232-2732
(310) 945-3350
(310) 840-7023
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00527
LEGAL ENTITY NUMBER
—
05
—
7890
—
CA
Enumeration date
10/17/2013
Last updated
09/08/2014
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