Provider Demographics
NPI:1437846656
Name:SIMONDS DETOX
Entity Type:Organization
Organization Name:SIMONDS DETOX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KARINE
Authorized Official - Middle Name:
Authorized Official - Last Name:TOROSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-995-8069
Mailing Address - Street 1:17810 SIMONDS ST
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-3309
Mailing Address - Country:US
Mailing Address - Phone:310-995-8069
Mailing Address - Fax:
Practice Address - Street 1:17810 SIMONDS ST
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-3309
Practice Address - Country:US
Practice Address - Phone:310-995-8069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-18
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility