Provider Demographics
NPI:1609364769
Name:ELITE VENTURES INC
Entity Type:Organization
Organization Name:ELITE VENTURES INC
Other - Org Name:AMBIANCE DETOX AND RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVIT
Authorized Official - Middle Name:
Authorized Official - Last Name:TRASHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-640-8221
Mailing Address - Street 1:13373 WENTWORTH ST
Mailing Address - Street 2:
Mailing Address - City:ARLETA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-6346
Mailing Address - Country:US
Mailing Address - Phone:855-500-3386
Mailing Address - Fax:747-247-2174
Practice Address - Street 1:13373 WENTWORTH ST
Practice Address - Street 2:
Practice Address - City:ARLETA
Practice Address - State:CA
Practice Address - Zip Code:91331-6346
Practice Address - Country:US
Practice Address - Phone:818-601-2009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-24
Last Update Date:2018-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility