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6260 Laurel Canyon Blvd Ste 103 North Hollywood CA 91606-3238 | |
| (747) 204-8884 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 6260 Laurel Canyon Blvd Ste 103, North Hollywood, California |
| Authorized Official Name and Position | Narek Oganyan (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 8185248605 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6260 Laurel Canyon Blvd Ste 103 North Hollywood CA 91606-3238 Ph: (424) 333-1823 | 6260 Laurel Canyon Blvd Ste 103 North Hollywood CA 91606-3238 Ph: (747) 204-8884 |
| NPI Number | 1811223076 |
|---|---|
| Provider Enumeration Date | 10/23/2009 |
| Last Update Date | 05/23/2024 |
| Certification Date | 05/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811223076 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
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