Provider Demographics
NPI:1609385764
Name:AMERICAN CARE RECOVERY CENTER, LLC
Entity Type:Organization
Organization Name:AMERICAN CARE RECOVERY CENTER, LLC
Other - Org Name:PARADISE COVE RECOVERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMELLA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BABAYOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-439-3815
Mailing Address - Street 1:10525 CHURCHILL AVE
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-2231
Mailing Address - Country:US
Mailing Address - Phone:818-439-3518
Mailing Address - Fax:
Practice Address - Street 1:1248 ROCKY RD
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-4835
Practice Address - Country:US
Practice Address - Phone:818-439-3518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-21
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder