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General NPI Number Information
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NPI Number | 1093493652
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Entity Type | Organization
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Legal Business Name | CARRARA TREATMENT WELLNESS & SPA
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Dates
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Enumeration Date | 07/05/2023
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 1814 MARCHEETA PL
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City | LOS ANGELES
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State | CA
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Zip | 90069-1116
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Country | US
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Telephone | 424-421-6610
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Fax | 213-334-4100
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Provider Business Mailing Address
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Address Line | 1814 MARCHEETA PL
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City | LOS ANGELES
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State | CA
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Zip | 90069-1116
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Country | US
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Telephone | 424-421-6610
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Fax | 213-334-4100
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Authorized Official
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Title or Position | CFO
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Name | MR. DANIEL CHRISTIAN
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Credential |
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Telephone | 205-712-2153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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