LOS ANGELES DETOX LLC NPI 1154906220

NPI Information

LOS ANGELES DETOX LLC is a substance abuse rehabilitation facility in Tarzana, 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. LOS ANGELES DETOX LLC NPI is 1154906220. The provider is registered as an organization entity type.

The provider's business location address is:

5537 SYLVIA AVE
TARZANA, CA
ZIP 91356-119
Phone: (310) 795-0542

The provider's authorized official is Yosef Grossman .
The authorized official title is Ceo and has the following contact phone number (310) 795-0542.

The CLIA number assigned to this NPI record is 05D0559170 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 3/10/2021 and was last updated on 8/31/2023.

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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