Provider Demographics
NPI:1376232728
Name:MAS PRO GROUP LLC
Entity Type:Organization
Organization Name:MAS PRO GROUP LLC
Other - Org Name:WISH RECOVERY IOP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MIKAYEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAKOBYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-232-4283
Mailing Address - Street 1:9846 WHITE OAK AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-4806
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9846 WHITE OAK AVE STE 204
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-4806
Practice Address - Country:US
Practice Address - Phone:747-333-8884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-02
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health