Organization · NPI-2

Advance Life Recovery

Substance Abuse Rehabilitation Facility · Northridge, CA

NPI number1245121805
StatusActive
Last updated in NPPESJul 11, 2025

Details

NPI
1245121805
Entity type
Organization (NPI-2)
Legal business name
Advance Life Recovery
Organization subpart
No
Enumeration date
Jul 11, 2025
Certification date
Jul 11, 2025
Last updated
Jul 11, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
324500000X Substance Abuse Rehabilitation Facility––Yes

Practice location

9350 Tampa Ave
Northridge, CA 91324-2744

Phone 888-929-2891 · Fax 818-483-9859

Mailing address

9350 Tampa Ave
Northridge, CA 91324-2744

Phone 888-929-2891 · Fax 818-483-9859

Authorized official

Davit Ksachikyan
Ceo
8889292891

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