MEDICARE: UPLIFT RECOVERY NOHO LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1063272896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPLIFT RECOVERY NOHO LLC

Provider Business Mailing Address
First Line	:	7710 AMPERE AVE
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91605-1903
Country	:	US
Telephone Number	:	310-674-4444
Fax Number	:

Provider Business Practice Location Address
First Line	:	7710 AMPERE AVE
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91605-1903
Country	:	US
Telephone Number	:	310-674-4444
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. HRATCH JABOURIAN
Credential	:
Telephone Number	:	310-674-4444

Provider Enumeration Date	:	03/20/2024
Last Update Date	:	02/10/2026

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Directions to “UPLIFT RECOVERY NOHO LLC ” Practice Location

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