Organization · NPI-2
11:11 Recovery
Clinic/Center, Rehabilitation, Substance Use Disorder · Valley Village, CA
NPI number1750132676
StatusActive
Last updated in NPPESSep 16, 2024
Details
- NPI
- 1750132676
- Entity type
- Organization (NPI-2)
- Legal business name
- 11:11 Recovery
- Organization subpart
- No
- Enumeration date
- Mar 28, 2024
- Certification date
- Sep 16, 2024
- Last updated
- Sep 16, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0405X | Clinic/Center, Rehabilitation, Substance Use Disorder | – | – | Yes |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – |
Practice location
5352 Laurel Canyon Blvd Ste 203Valley Village, CA 91607-4958
Phone 818-726-9999
Mailing address
5352 Laurel Canyon Blvd Ste 203Valley Village, CA 91607-4958
Authorized official
Kristina Kasabyan
Ceo
8187269999
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