Healthcare Provider Details

I. General information

NPI: 1821935693
Provider Name (Legal Business Name): LIVING LIFE RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3057 N NAOMI ST
BURBANK CA
91504-1733
US

IV. Provider business mailing address

3057 N NAOMI ST
BURBANK CA
91504-1733
US

V. Phone/Fax

Practice location:
  • Phone: 940-900-0009
  • Fax: 940-900-0009
Mailing address:
  • Phone: 940-900-0009
  • Fax: 940-900-0009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: DAVIT KOSTANYAN
Title or Position: CEO
Credential:
Phone: 940-900-0009