Healthcare Provider Details

I. General information

NPI: 1184473795
Provider Name (Legal Business Name): AVALANCHE RECOVERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2024
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14930 VENTURA BLVD STE 300
SHERMAN OAKS CA
91403-3489
US

IV. Provider business mailing address

14930 VENTURA BLVD STE 300
SHERMAN OAKS CA
91403-3489
US

V. Phone/Fax

Practice location:
  • Phone: 818-515-8800
  • Fax:
Mailing address:
  • Phone: 818-515-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: MERUZHAN AKOPYAN
Title or Position: CEO
Credential:
Phone: 818-631-1545