SPARKLES KC LLC NPI 1073962791

NPI Information

SPARKLES KC LLC is a substance abuse rehabilitation facility in Villa Park, CA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. SPARKLES KC LLC NPI is 1073962791. The provider is registered as an organization entity type.
The provider Is Doing Business As Path To Serenity.

The provider's business location address is:

10002 BRILEY WAY
VILLA PARK, CA
ZIP 92861-219
Phone: (949) 289-0350

The provider's authorized official is Izzy Hirson .
The authorized official title is Ceo and has the following contact phone number (949) 289-0350.

The enumeration date for this NPI number is 6/3/2016 and was last updated on 6/3/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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