Healthcare Provider Details

I. General information

NPI: 1396600490
Provider Name (Legal Business Name): ZOR REVIVAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20251 VENTURA BLVD STE B
WOODLAND HILLS CA
91364-2565
US

IV. Provider business mailing address

20251 VENTURA BLVD STE B
WOODLAND HILLS CA
91364-2565
US

V. Phone/Fax

Practice location:
  • Phone: 747-745-2104
  • Fax:
Mailing address:
  • Phone: 747-745-2104
  • 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: MR. ANGEL COOPER
Title or Position: CEO
Credential:
Phone: 747-745-2104