Provider Demographics
NPI:1598139693
Name:ACTIVE RECOVERY SOLUTIONS LLC
Entity Type:Organization
Organization Name:ACTIVE RECOVERY SOLUTIONS LLC
Other - Org Name:VALLEY DETOX CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRESNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-544-6049
Mailing Address - Street 1:15120 VOSE ST
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-2935
Mailing Address - Country:US
Mailing Address - Phone:888-544-6049
Mailing Address - Fax:
Practice Address - Street 1:15120 VOSE ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2935
Practice Address - Country:US
Practice Address - Phone:888-544-6049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-30
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility