Provider Demographics
NPI:1821771122
Name:RISE IN GLENDALE SOBRIETY CENTER
Entity Type:Organization
Organization Name:RISE IN GLENDALE SOBRIETY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:AKOPYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-818-7509
Mailing Address - Street 1:3449 STANCREST DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-1319
Mailing Address - Country:US
Mailing Address - Phone:818-395-7137
Mailing Address - Fax:
Practice Address - Street 1:3449 STANCREST DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-1319
Practice Address - Country:US
Practice Address - Phone:818-395-7137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder