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General NPI Number Information
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NPI Number | 1407661713
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Entity Type | Organization
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Legal Business Name | RECOVERY DYNAMICS LLC
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Dates
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Enumeration Date | 02/12/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 948 S COCHRAN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90036-4739
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Country | US
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Telephone | 213-333-3869
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Fax |
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Provider Business Mailing Address
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Address Line | 1776 N HIGHLAND AVE
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City | LOS ANGELES
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State | CA
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Zip | 90028-4404
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER MANAGER
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Name | MR. REZA FARAZMAND
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Credential |
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Telephone | 310-266-7484
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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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