Healthcare Provider Details

I. General information

NPI: 1003767997
Provider Name (Legal Business Name): PROMISE RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2026
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7335 TOPANGA CANYON BLVD STE 2A
CANOGA PARK CA
91303-1255
US

IV. Provider business mailing address

7335 TOPANGA CANYON BLVD STE 2A
CANOGA PARK CA
91303-1255
US

V. Phone/Fax

Practice location:
  • Phone: 818-813-7107
  • Fax: 818-484-2389
Mailing address:
  • Phone: 818-724-8004
  • Fax: 818-484-2389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EDGAR KOLOZYAN
Title or Position: CEO
Credential:
Phone: 818-724-8004