MEDICARE: ACCESS TO RECOVERY 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

General Provider Information

NPI Number	:	1720941420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCESS TO RECOVERY DETOX CENTER INC

Provider Business Mailing Address
First Line	:	15363 LEADWELL ST
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91406-3354
Country	:	US
Telephone Number	:	747-303-0001
Fax Number	:

Provider Business Practice Location Address
First Line	:	15363 LEADWELL ST
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91406-3354
Country	:	US
Telephone Number	:	737-303-0001
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. ARTUR MARGARYAN
Credential	:
Telephone Number	:	747-303-0001

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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