Healthcare Provider Details

I. General information

NPI: 1316884109
Provider Name (Legal Business Name): REST AND RISE RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19138 HARTLAND ST
RESEDA CA
91335-3802
US

IV. Provider business mailing address

19138 HARTLAND ST
RESEDA CA
91335-3802
US

V. Phone/Fax

Practice location:
  • Phone: 818-359-6959
  • Fax:
Mailing address:
  • Phone: 818-359-6959
  • 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: EKATERINA YEDIGAROVA
Title or Position: CEO
Credential:
Phone: 818-359-6959