MEDICARE: EXODUS RECOVERY, 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1912216680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXODUS RECOVERY, INC.

Provider Business Mailing Address
First Line	:	9808 VENICE BLVD STE 700
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90232-6824
Country	:	US
Telephone Number	:	310-945-3350
Fax Number	:	310-945-3355

Provider Business Practice Location Address
First Line	:	8607 VENICE BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90034-2518
Country	:	US
Telephone Number	:	310-253-9494
Fax Number	:	310-253-9495

Authorized Official
Title or Position	:	CFO
Name	:	MS. LEEANN SKOROHOD
Credential	:
Telephone Number	:	310-945-3350

Provider Enumeration Date	:	09/29/2010
Last Update Date	:	06/03/2026

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