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General NPI Number Information
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NPI Number | 1992338255
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Entity Type | Organization
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Legal Business Name | AIM 4 RECOVERY
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Dates
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Enumeration Date | 02/14/2020
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Last Update Date | 02/14/2020
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Provider Practice Location Address
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Address Line | 2948 1/2 HONOLULU AVE
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City | LA CRESCENTA
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State | CA
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Zip | 91214-3909
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Country | US
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Telephone | 818-351-2337
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Fax |
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Provider Business Mailing Address
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Address Line | 2948 1/2 HONOLULU AVE
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City | LA CRESCENTA
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State | CA
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Zip | 91214-3909
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Country | US
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Telephone | 818-351-2337
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MRS. ANGELIQUE NICOLE SHIRVANIAN
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Credential | CADC-II
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Telephone | 818-351-2337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #5
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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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