Provider Demographics
NPI:1003523242
Name:AAA RECOVERY LLC
Entity Type:Organization
Organization Name:AAA RECOVERY LLC
Other - Org Name:NAIRI REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:POGHOSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-913-5404
Mailing Address - Street 1:15839 GAULT ST
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-5152
Mailing Address - Country:US
Mailing Address - Phone:818-913-5404
Mailing Address - Fax:
Practice Address - Street 1:11811 1/2 DARLENE LN
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-1020
Practice Address - Country:US
Practice Address - Phone:818-913-5404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility