MEDICARE: Y & Y RECOVERY

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	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1811403116
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	Y & Y RECOVERY

Provider Business Mailing Address
First Line	:	1123 N ALEXANDRIA AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-1407
Country	:	US
Telephone Number	:	323-928-2568
Fax Number	:

Provider Business Practice Location Address
First Line	:	1123 N ALEXANDRIA AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-1407
Country	:	US
Telephone Number	:	818-602-1622
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	SANDY ROSILES
Credential	:
Telephone Number	:	323-928-2568

Provider Enumeration Date	:	12/21/2017
Last Update Date	:	06/29/2022

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Directions to “Y & Y RECOVERY ” Practice Location

Language	Start Address	Practice Location

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