Provider Demographics
NPI:1760098875
Name:LUXURY REHAB GROUP, LLC.
Entity Type:Organization
Organization Name:LUXURY REHAB GROUP, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHILATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-234-2060
Mailing Address - Street 1:31739 PACIFIC COAST HWY
Mailing Address - Street 2:
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265-2643
Mailing Address - Country:US
Mailing Address - Phone:424-235-2012
Mailing Address - Fax:
Practice Address - Street 1:123 HODENCAMP RD STE 103
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5833
Practice Address - Country:US
Practice Address - Phone:805-777-7595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEASONS RECOVERY CENTERS, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health