Provider Demographics
NPI:1801348305
Name:DESTINATIONS TO RECOVERY, LLC
Entity type:Organization
Organization Name:DESTINATIONS TO RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ALON
Authorized Official - Last Name:SAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-737-2221
Mailing Address - Street 1:21051 WARNER CENTER LN
Mailing Address - Street 2:SUITE 220
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6551
Mailing Address - Country:US
Mailing Address - Phone:818-737-2221
Mailing Address - Fax:818-737-2222
Practice Address - Street 1:6222 WILSHIRE BLVD
Practice Address - Street 2:SUITE 313
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5123
Practice Address - Country:US
Practice Address - Phone:818-737-2221
Practice Address - Fax:818-737-2222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190842BP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility