Healthcare Provider Details

I. General information

NPI: 1558028266
Provider Name (Legal Business Name): RFTI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2021
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1746 ABBOT KINNEY BLVD
VENICE CA
90291-4839
US

IV. Provider business mailing address

1237 7TH ST
SANTA MONICA CA
90401-1605
US

V. Phone/Fax

Practice location:
  • Phone: 818-926-1982
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: MARK RIZKALLAH
Title or Position: COO
Credential:
Phone: 818-926-1982