Provider Demographics
NPI:1811169105
Name:STAIRWAY TO RECOVERY DRUG AND ALCOHOL REHABILITAITON FACILITY
Entity type:Organization
Organization Name:STAIRWAY TO RECOVERY DRUG AND ALCOHOL REHABILITAITON FACILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICE
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHRAWNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-236-7765
Mailing Address - Street 1:6102 SOUTH BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90003-1428
Mailing Address - Country:US
Mailing Address - Phone:323-526-1073
Mailing Address - Fax:
Practice Address - Street 1:6102 SOUTH BROADWAY
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90003-1428
Practice Address - Country:US
Practice Address - Phone:661-236-7765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility