Healthcare Provider Details

I. General information

NPI: 1679407985
Provider Name (Legal Business Name): CARE PRO RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4363 WOODMAN AVE
SHERMAN OAKS CA
91423-3030
US

IV. Provider business mailing address

4363 WOODMAN AVE
SHERMAN OAKS CA
91423-3030
US

V. Phone/Fax

Practice location:
  • Phone: 909-653-9499
  • Fax:
Mailing address:
  • Phone: 909-653-9499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY BROWN
Title or Position: OWNER
Credential: LPCC
Phone: 909-653-9499