Provider Demographics
NPI:1013625250
Name:REGGIES RECOVERY, LLC
Entity Type:Organization
Organization Name:REGGIES RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:SPENCER
Authorized Official - Last Name:SMARIO
Authorized Official - Suffix:
Authorized Official - Credentials:RAC
Authorized Official - Phone:818-940-6697
Mailing Address - Street 1:1411 N AVON ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-1818
Mailing Address - Country:US
Mailing Address - Phone:818-478-1575
Mailing Address - Fax:
Practice Address - Street 1:1411 N AVON ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-1818
Practice Address - Country:US
Practice Address - Phone:818-478-1575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilityGroup - Single Specialty