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NPI Code Detail

MEDICARE: BEIT T'SHUVAH

MEDICARE: BEIT T'SHUVAH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor190326ANCA
2324500000XSubstance Abuse Rehabilitation Facility190326ANCA

General Provider Information

NPI Number : 1396926754
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEIT T'SHUVAH
Provider Business Mailing Address
First Line : 8831 VENICE BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90034-3223
Country : US
Telephone Number : 310-204-5200
Fax Number : 310-838-3545
Provider Business Practice Location Address
First Line : 8831 VENICE BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90034-3223
Country : US
Telephone Number : 310-204-5200
Fax Number : 310-838-3545
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : SERGIO RIZZO-FONTANESI
Credential : PHD
Telephone Number : 310-204-5200
Provider Enumeration Date : 11/14/2007
Last Update Date : 08/18/2020

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1922239425 — BEIT T'SHUVAH
Practice Location Address:
8831 VENICE BLVD
LOS ANGELES, CA
90034-3223
Practice Phone: 310-204-5200
Practice Fax: 310-838-3545

Directions to “BEIT T'SHUVAH ” Practice Location

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