Provider Demographics
NPI:1558129957
Name:LOVE & LIGHT RECOVERY CENTER INC
Entity Type:Organization
Organization Name:LOVE & LIGHT RECOVERY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:SISAK
Authorized Official - Middle Name:
Authorized Official - Last Name:SARIBEKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-908-4922
Mailing Address - Street 1:11915 STRATHERN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605-1413
Mailing Address - Country:US
Mailing Address - Phone:909-908-4922
Mailing Address - Fax:
Practice Address - Street 1:11915 STRATHERN ST
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91605-1413
Practice Address - Country:US
Practice Address - Phone:909-908-4922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder