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General NPI Number Information
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NPI Number | 1154219681
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Entity Type | Organization
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Legal Business Name | REGAIN HOPE DETOX AND RECOVERY CENTER INC
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 1134 N LIMA ST
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City | BURBANK
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State | CA
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Zip | 91505-2533
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Country | US
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Telephone | 305-613-2642
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6631
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City | BURBANK
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State | CA
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Zip | 91510-6631
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Country | US
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Telephone | 305-613-2642
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Fax | 409-231-5016
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MILEIDYS GOMEZ GONZALEZ
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Credential | MD
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Telephone | 305-613-2642
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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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