MEDICARE: BLVD CENTERS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center	190810AP	CA
2	324500000X	Substance Abuse Rehabilitation Facility		CA

General Provider Information

NPI Number	:	1356768089
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLVD CENTERS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 512030
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90051-0030
Country	:	US
Telephone Number	:	855-277-5363
Fax Number	:

Provider Business Practice Location Address
First Line	:	1776 N HIGHLAND AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-4404
Country	:	US
Telephone Number	:	424-281-6143
Fax Number	:	424-216-0574

Authorized Official
Title or Position	:	COO
Name	:	MR. JASON MONROE
Credential	:
Telephone Number	:	602-550-2211

Provider Enumeration Date	:	03/19/2014
Last Update Date	:	07/28/2017

Similar Medicare Providers

1972351716 — RECOVERY DYNAMICS LLC
Practice Location Address:

1776 N HIGHLAND AVE
LOS ANGELES, CA
90028-4404

Practice Phone: 213-333-3869
Practice Fax:

1740723006 — HELPING HANDS REHABILITATION CLINIC
Practice Location Address:

1776 N HIGHLAND AVE
LOS ANGELES, CA
90028-4404

Practice Phone: 213-479-0900
Practice Fax:

1093229593 — BLVD CENTERS, INC.
Practice Location Address:

1776 N HIGHLAND AVE
LOS ANGELES, CA
90028-4404

Practice Phone: 561-515-3227
Practice Fax: 561-515-3235

1437228962 — LINDA DONOFRIO
Practice Location Address:

6000 SAN VICENTE BLVD
LOS ANGELES, CA
90036-4404

Practice Phone: 310-350-0606
Practice Fax:

1184773202 — MIRACLE MILE MEDICAL CENTER, LLC
Practice Location Address:

6000 SAN VICENTE BLVD
LOS ANGELES, CA
90036-4404

Practice Phone: 323-930-1040
Practice Fax: 323-937-0525

1063620383 — DR. SAMUEL GEGAMIAN DMD
Practice Location Address:

336 1/2 N MARIPOSA AVE
LOS ANGELES, CA
90004-4404

Practice Phone: 818-276-5603
Practice Fax:

Directions to “BLVD CENTERS, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.