| Nautilus Recovery Group, Inc | |
|
5803 Corbin Ave Tarzana CA 91356-1004 | |
| (734) 751-4956 | |
| Not Available |
| Full Name | Nautilus Recovery Group, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5803 Corbin Ave, Tarzana, California |
| Authorized Official Name and Position | Jason Vaughn Shoemaker (CEO) |
| Authorized Official Contact | 3107954066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nautilus Recovery Group, Inc 8033 W Sunset Blvd # 946 West Hollywood CA 90046-2401 Ph: (310) 795-4066 | Nautilus Recovery Group, Inc 5803 Corbin Ave Tarzana CA 91356-1004 Ph: (734) 751-4956 |
| NPI Number | 1629552542 |
|---|---|
| Provider Enumeration Date | 09/17/2018 |
| Last Update Date | 09/06/2023 |
| Certification Date | 05/06/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629552542 | NPI | - | NPPES |
| 816290448 | Other | CA | CCAPPP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Secondary |
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