Healthcare Provider Details

I. General information

NPI: 1578919585
Provider Name (Legal Business Name): HK MANAGMENT COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2016
Last Update Date: 07/29/2020
Certification Date: 07/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3415 OVERLAND AVE
LOS ANGELES CA
90034-5405
US

IV. Provider business mailing address

10533 WASHINGTON BLVD
CULVER CITY CA
90232-3311
US

V. Phone/Fax

Practice location:
  • Phone: 310-901-6290
  • Fax:
Mailing address:
  • Phone: 310-663-8890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number190950AP
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number190950AP
License Number StateCA

VIII. Authorized Official

Name: MR. MATTHEW ZIERING
Title or Position: CFO
Credential:
Phone: 310-663-8890