Healthcare Provider Details

I. General information

NPI: 1093129306
Provider Name (Legal Business Name): WESTSIDE TREATMENT, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

Provider Other Name: THE HEIGHTS TREATMENT CA

II. Dates (important events)

Enumeration Date: 06/13/2014
Last Update Date: 10/28/2022
Certification Date: I will like to change the Provider's Other Name Information Provider Other Organization Name: from THE HEIGHTS TREATMENT CA to The Heights Los Angeles Drug Rehab & Mental Health Treatment
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11150 W OLYMPIC BLVD STE 760
LOS ANGELES CA
90064-1817
US

IV. Provider business mailing address

11150 W OLYMPIC BLVD STE 760
LOS ANGELES CA
90064-1855
US

V. Phone/Fax

Practice location:
  • Phone: 888-995-7687
  • Fax: 310-943-3883
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ADAM B ZAGHA
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 424-835-6506