Healthcare Provider Details

I. General information

NPI: 1841081007
Provider Name (Legal Business Name): SKID ROW RELIEF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2025
Last Update Date: 05/15/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12021 WILSHIRE BLVD UNIT 552
LOS ANGELES CA
90025-1206
US

IV. Provider business mailing address

12021 WILSHIRE BLVD # 552
LOS ANGELES CA
90025-1206
US

V. Phone/Fax

Practice location:
  • Phone: 213-697-3683
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CAULAIN SAPER
Title or Position: MANAGER
Credential:
Phone: 213-697-3683