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General NPI Number Information
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NPI Number | 1629507595
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Entity Type | Organization
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Legal Business Name | RECOVERY ADVOCATES, LLC
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Dates
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Enumeration Date | 06/05/2017
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Last Update Date | 04/23/2019
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Provider Practice Location Address
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Address Line | 1800 BRIDGEGATE ST STE 204
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-1459
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Country | US
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Telephone | 805-371-7877
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Fax | 805-557-1999
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Provider Business Mailing Address
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Address Line | 1014 S WESTLAKE BLVD SUITE # 14-275
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-3108
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Country | US
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Telephone | 561-267-8481
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Fax | 805-557-1999
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Authorized Official
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Title or Position | CEO/EXECUTIVE DIRECTOR
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Name | MR. STUART D. BIMBAUM
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Credential |
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Telephone | 561-267-8481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 17-00034798
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License Number State | CA
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