Healthcare Provider Details

I. General information

NPI: 1811223076
Provider Name (Legal Business Name): HOLY ADDICTION CARE CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2009
Last Update Date: 05/23/2024
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6260 LAUREL CANYON BLVD STE 103
NORTH HOLLYWOOD CA
91606-3238
US

IV. Provider business mailing address

6260 LAUREL CANYON BLVD STE 103
NORTH HOLLYWOOD CA
91606-3238
US

V. Phone/Fax

Practice location:
  • Phone: 747-204-8884
  • Fax:
Mailing address:
  • Phone: 424-333-1823
  • Fax: 213-481-9944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NAREK OGANYAN
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 818-524-8605