| Tavarua Rehabilitation Services | |
|
474 S Citrus Ave Azusa CA 91702-4733 | |
| (626) 858-9500 | |
| (626) 858-9090 |
| Full Name | Tavarua Rehabilitation Services |
|---|---|
| Speciality | Clinic/center - Methadone |
| Location | 474 S Citrus Ave, Azusa, California |
| Authorized Official Name and Position | Pramesh P Sharma (ADMINISTRAT DIRECTOR) |
| Authorized Official Contact | 6613135503 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tavarua Rehabilitation Services 474 S Citrus Ave Azusa CA 91702-4733 Ph: (626) 858-9500 | Tavarua Rehabilitation Services 474 S Citrus Ave Azusa CA 91702-4733 Ph: (626) 858-9500 |
| NPI Number | 1841679131 |
|---|---|
| Provider Enumeration Date | 05/20/2015 |
| Last Update Date | 06/28/2024 |
| Certification Date | 06/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841679131 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | RW4776 (California) | Secondary |
| 261QM2800X | Clinic/center - Methadone | (* (Not Available)) | Primary |
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