Healthcare Provider Details

I. General information

NPI: 1518765130
Provider Name (Legal Business Name): EXCLUSIVE RECOVERY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10630 SEPULVEDA BLVD STE 202
MISSION HILLS CA
91345-1938
US

IV. Provider business mailing address

10630 SEPULVEDA BLVD STE 202
MISSION HILLS CA
91345-1938
US

V. Phone/Fax

Practice location:
  • Phone: 747-253-7042
  • Fax:
Mailing address:
  • Phone: 747-500-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HAYK SARGSYAN
Title or Position: CEO
Credential:
Phone: 747-500-7070