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Revive Detox
Substance Abuse Rehabilitation Facility in Los Angeles, California
NPI 1639561566

Revive Detox is a Substance Abuse Rehabilitation Facility based in Los Angeles, CA. Revive Detox practices in Los Angeles, CA. The NPI Number for Revive Detox is 1639561566 and holds a License No. 190836AP (California).

The current practice location address for Revive Detox is 360 N Vista St, Los Angeles, CA and can be reached out via phone at 818-462-3824.

Location: 360 N Vista St, Los Angeles, CA, 90036-5739
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1639561566
Provider Name
Revive Detox
Credential
Provider Entity Type
Organization
Address
360 N Vista St, Los Angeles, CA, 90036-5739
Phone Number
818-462-3824
Fax Number
Provider Enumeration Date
03/02/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
360 N Vista St
City
Los Angeles
State
California
Zip
90036-5739
Phone Number
818-462-3824
Fax Number
person
Provider Business Mailing Address Details
Address
360 N Vista St
City
Los Angeles
State
California
Zip
90036-5739
Phone Number
818-462-3824
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
-
Taxonomy
324500000X
License No.
190836AP (California)
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
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