Healthcare Provider Details

I. General information

NPI: 1508788795
Provider Name (Legal Business Name): ALPHA LUXURYRECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 ALPHA RD
GLENDALE CA
91208-2109
US

IV. Provider business mailing address

1907 ALPHA RD
GLENDALE CA
91208-2109
US

V. Phone/Fax

Practice location:
  • Phone: 310-962-8852
  • Fax: 310-962-8852
Mailing address:
  • Phone: 310-962-8852
  • Fax: 310-962-8852

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: ALEXANDER MARGARIAN
Title or Position: CEO
Credential:
Phone: 310-962-8852