MEDICARE: LIVING LIFE RECOVERY

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	:	1821935693
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVING LIFE RECOVERY

Provider Business Mailing Address
First Line	:	3057 N NAOMI ST
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91504-1733
Country	:	US
Telephone Number	:	940-900-0009
Fax Number	:	940-900-0009

Provider Business Practice Location Address
First Line	:	3057 N NAOMI ST
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91504-1733
Country	:	US
Telephone Number	:	940-900-0009
Fax Number	:	940-900-0009

Authorized Official
Title or Position	:	CEO
Name	:	DAVIT KOSTANYAN
Credential	:
Telephone Number	:	940-900-0009

Provider Enumeration Date	:	04/30/2026
Last Update Date	:	04/30/2026

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Directions to “LIVING LIFE RECOVERY ” Practice Location

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