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General NPI Number Information
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NPI Number | 1366792269
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Entity Type | Organization
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Legal Business Name | LIVING REBOS, LLC
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 01/18/2017
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Provider Practice Location Address
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Address Line | 1772 S ROBERTSON BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90035
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Country | US
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Telephone | 310-694-5590
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Fax | 310-694-3278
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Provider Business Mailing Address
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Address Line | 1772 S ROBERTSON BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90035
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Country | US
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Telephone | 310-694-5590
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Fax | 310-694-3278
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Authorized Official
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Title or Position | OWNER
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Name | MR. ROSS REMIEN
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Credential |
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Telephone | 310-694-5590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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