MEDICARE: MONTEBELLO RECOVERY CENTER

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	:	1821925819
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTEBELLO RECOVERY CENTER

Provider Business Mailing Address
First Line	:	1018 W YORKTOWN AVE
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-2557
Country	:	US
Telephone Number	:	323-314-9464
Fax Number	:	323-314-9464

Provider Business Practice Location Address
First Line	:	1018 W YORKTOWN AVE
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-2557
Country	:	US
Telephone Number	:	323-314-9464
Fax Number	:	323-314-9464

Authorized Official
Title or Position	:	CFO
Name	:	YENOK KOPUSHYAN
Credential	:
Telephone Number	:	323-314-9464

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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Directions to “MONTEBELLO RECOVERY CENTER ” Practice Location

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