4 SEASON DETOX AND RECOVERY HOUSE INC — NPI 1508534934 (Licensed & Credentialed Substance Abuse Rehabilitation Facility in SIMI VALLEY, CA)

CMS-1500 Box 24J / 33a • NPI

1508534934

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

324500000X

Licensed & Credentialed Substance Abuse Rehabilitation Facility

Box 32 Service Location & ZIP+4

3174 EVELYN AVE, SIMI VALLEY, CA, 93063-1568

✓ 9-Digit EDI 837 ZIP+4 (93063-1568)

Practice Phone & Referral Fax

(424) 242-2540

Fax: (661) 296-2836

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1508534934 (4 SEASON DETOX AND RECOVERY HOUSE INC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1508534934` (NPI-2 Organization / Facility)
Provider / Legal Name	4 SEASON DETOX AND RECOVERY HOUSE INC
Plain-English Specialty	Licensed & Credentialed Substance Abuse Rehabilitation Facility NUCC Code: `324500000X` (Substance Abuse Rehabilitation Facility)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	3174 EVELYN AVE, SIMI VALLEY, CA, 93063-1568
Practice Telephone / Fax	Tel: (424) 242-2540 \| Fax: (661) 296-2836
Administrative Mailing Address	3174 EVELYN AVE, SIMI VALLEY, CA, 93063-1568
Enumeration & Last Sync	Enumerated: 2021-08-31 \| CMS Record Updated: 2023-04-28
Authorized Official	ARSEN SAROYAN (Secretary)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

3174 EVELYN AVE, SIMI VALLEY, CA, 93063-1568

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Plain-English Taxonomy & CMS Crosswalk (324500000X)

What Does Taxonomy Code 324500000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 324500000X translates to:
"Licensed & Credentialed Substance Abuse Rehabilitation Facility"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Substance Abuse Rehabilitation Facility for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (4 SEASON DETOX AND RECOVERY HOUSE INC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`324500000X` — Substance Abuse Rehabilitation Facility Plain English: Licensed & Credentialed Substance Abuse Rehabilitation Facility	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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4 SEASON DETOX AND RECOVERY HOUSE INC (NPI #1508534934)