SPARK TO RECOVERY INC NPI 1144867060

NPI Information

SPARK TO RECOVERY INC is a substance abuse rehabilitation facility in Sherman Oaks, 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. SPARK TO RECOVERY INC NPI is 1144867060. The provider is registered as an organization entity type.
The provider Is Doing Business As Concise Detox Center.

The provider's business location address is:

5449 WOODMAN AVE
SHERMAN OAKS, CA
ZIP 91401-832
Phone: (818) 818-0202

The provider's authorized official is Nicholas Mathews .
The authorized official title is Director and has the following contact phone number (503) 791-3205.

The CLIA number assigned to this NPI record is 05D2233458 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/10/2019 and was last updated on 9/15/2021.

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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