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LIFESYNC RECOVERY AND DETOXIFICATION LLC NPI 1730632159


NPI Information

NPI: 1730632159
Provider Name: LIFESYNC RECOVERY AND DETOXIFICATION, LLC
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 05D2129767

Address:
28632 ROADSIDE DR
SUITE 235
AGOURA HILLS, CA
ZIP 91301
Phone: (310) 951-6340
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LIFESYNC RECOVERY AND DETOXIFICATION, LLC is a substance abuse rehabilitation facility in Agoura Hills, 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. LIFESYNC RECOVERY AND DETOXIFICATION, LLC NPI is 1730632159. The provider is registered as an organization entity type.

The provider's business location address is:

28632 ROADSIDE DR
SUITE 235
AGOURA HILLS, CA
ZIP 91301-064
Phone: (310) 951-6340

The provider's authorized official is Geoffrey A Booth .
The authorized official title is Owner and has the following contact phone number (310) 951-6340.

The CLIA number assigned to this NPI record is 05D2129767 - other - detox with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/2/2016 and was last updated on 8/2/2016.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1324500000XSubstance Abuse Rehabilitation Facility190920APCALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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