Healthcare Provider Details
I. General information
NPI: 1659400638
Provider Name (Legal Business Name): HAMBURGER HOME
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/05/2007
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7120 FRANKLIN AVE
LOS ANGELES CA
90046-3002
US
IV. Provider business mailing address
7120 FRANKLIN AVE
LOS ANGELES CA
90046-3002
US
V. Phone/Fax
- Phone: 323-876-5000
- Fax: 323-436-7042
- Phone: 323-876-5000
- Fax: 323-436-7042
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
AMBER
RIVAS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 323-876-0550