Healthcare Provider Details

I. General information

NPI: 1275340424
Provider Name (Legal Business Name): MONTE REHAB INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2024
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1741 LOMA RD
MONTEBELLO CA
90640-3234
US

IV. Provider business mailing address

1741 LOMA RD
MONTEBELLO CA
90640-3234
US

V. Phone/Fax

Practice location:
  • Phone: 323-919-9999
  • Fax:
Mailing address:
  • Phone: 323-919-9999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. GOR HABESHIAN
Title or Position: CEO
Credential:
Phone: 323-949-2030