MEDICARE: CURATIVE DETOX CENTER INC

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
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
2	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1518788538
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CURATIVE DETOX CENTER INC

Provider Business Mailing Address
First Line	:	8630 HASKELL AVE
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-5811
Country	:	US
Telephone Number	:	310-300-3833
Fax Number	:

Provider Business Practice Location Address
First Line	:	8630 HASKELL AVE
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-5811
Country	:	US
Telephone Number	:	310-300-3833
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. ARTOUR MIKAELIAN
Credential	:
Telephone Number	:	310-300-3833

Provider Enumeration Date	:	10/22/2024
Last Update Date	:	10/22/2024

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