Healthcare Provider Details

I. General information

NPI: 1548453228
Provider Name (Legal Business Name): A NEW CREATION/FOUNDATION ALL-N-RECOVERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 08/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 W WASHINGTON BLVD
LOS ANGELES CA
90015-4100
US

IV. Provider business mailing address

757 W WASHINGTON BLVD
LOS ANGELES CA
90015-4100
US

V. Phone/Fax

Practice location:
  • Phone: 323-253-7069
  • Fax:
Mailing address:
  • Phone: 323-253-7069
  • Fax:

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: MR. TOBIAS TAIT RHODES
Title or Position: PRESIDENT/CEO
Credential:
Phone: 323-253-7069