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General NPI Number Information
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NPI Number | 1144860073
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Entity Type | Organization
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Legal Business Name | STARBRIDGE RECOVERY, LLC
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Dates
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Enumeration Date | 01/08/2020
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 23104 MARIANO ST
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-6136
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Country | US
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Telephone | 323-872-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 23104 MARIANO ST
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-6136
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Country | US
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Telephone | 323-872-0000
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Fax |
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Authorized Official
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Title or Position | MGMT
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Name | ADAM SNYDER
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Credential |
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Telephone | 323-915-9088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 276400000X
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Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
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License Number |
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License Number State |
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Taxonomy #2
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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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