| Sherwood Detox | |
|
8854 Zelzah Ave Sherwood Forest CA 91325-2849 | |
| (818) 300-4788 | |
| Not Available |
| Full Name | Sherwood Detox |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 8854 Zelzah Ave, Sherwood Forest, California |
| Authorized Official Name and Position | Eugene Lutsenko (OWNER) |
| Authorized Official Contact | 8183004788 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sherwood Detox 8854 Zelzah Ave Sherwood Forest CA 91325-2849 Ph: () - | Sherwood Detox 8854 Zelzah Ave Sherwood Forest CA 91325-2849 Ph: (818) 300-4788 |
| NPI Number | 1760191480 |
|---|---|
| Provider Enumeration Date | 11/21/2022 |
| Last Update Date | 11/21/2022 |
| Certification Date | 11/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760191480 | NPI | - | NPPES |
| 370189AP | Other | CA | 191171AP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |