Provider Demographics
NPI:1184343485
Name:WILLPOWER RECOVERY LLC
Entity type:Organization
Organization Name:WILLPOWER RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHOT
Authorized Official - Middle Name:
Authorized Official - Last Name:GALADJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MR
Authorized Official - Phone:310-800-5554
Mailing Address - Street 1:2515 E WOODLYN RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-3449
Mailing Address - Country:US
Mailing Address - Phone:310-800-5554
Mailing Address - Fax:
Practice Address - Street 1:2515 E WOODLYN RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-3449
Practice Address - Country:US
Practice Address - Phone:310-800-5554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility