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NPI Code Detail

MEDICARE: AMERICAN CARE RECOVERY CENTER, LLC

MEDICARE: AMERICAN CARE RECOVERY CENTER, 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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number : 1609385764
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMERICAN CARE RECOVERY CENTER, LLC
Provider Business Mailing Address
First Line : 10525 CHURCHILL AVE
Second Line :
City : CHATSWORTH
State : CA
Zip : 91311-2231
Country : US
Telephone Number : 818-439-3518
Fax Number :
Provider Business Practice Location Address
First Line : 1248 ROCKY RD
Second Line :
City : SIMI VALLEY
State : CA
Zip : 93063-4835
Country : US
Telephone Number : 818-439-3518
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : RAMELLA R BABAYOVA
Credential :
Telephone Number : 818-439-3815
Provider Enumeration Date : 09/21/2017
Last Update Date : 09/21/2017

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Directions to “AMERICAN CARE RECOVERY CENTER, LLC ” Practice Location

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