Provider Demographics
NPI:1710591599
Name:FIRST STEP RECOVERY
Entity Type:Organization
Organization Name:FIRST STEP RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVRON
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHIDOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-606-3014
Mailing Address - Street 1:1620 CENTINELA AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302-1091
Mailing Address - Country:US
Mailing Address - Phone:323-606-3014
Mailing Address - Fax:
Practice Address - Street 1:1620 CENTINELA AVE STE 202
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-1091
Practice Address - Country:US
Practice Address - Phone:323-606-3014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility