Provider Demographics
NPI:1346613007
Name:EXIS RECOVERY INC
Entity Type:Organization
Organization Name:EXIS RECOVERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SPYRIDOULA
Authorized Official - Middle Name:
Authorized Official - Last Name:PREVENTZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-497-6248
Mailing Address - Street 1:2001 S BARRINGTON AVE
Mailing Address - Street 2:STE 219
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-5363
Mailing Address - Country:US
Mailing Address - Phone:310-497-6248
Mailing Address - Fax:
Practice Address - Street 1:2001 S BARRINGTON AVE
Practice Address - Street 2:STE 219
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5363
Practice Address - Country:US
Practice Address - Phone:310-497-6248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health