Provider Demographics
NPI:1710792817
Name:REFORM RECOVERY CENTER INC
Entity type:Organization
Organization Name:REFORM RECOVERY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ARMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:TARVERYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-590-5189
Mailing Address - Street 1:3022 N HOLLYWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-1026
Mailing Address - Country:US
Mailing Address - Phone:818-590-5189
Mailing Address - Fax:
Practice Address - Street 1:3022 N HOLLYWOOD WAY
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-1026
Practice Address - Country:US
Practice Address - Phone:818-590-5189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health