Provider Demographics
NPI:1932832151
Name:CASA LEONA RECOVERY CENTER INC.
Entity Type:Organization
Organization Name:CASA LEONA RECOVERY CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:VREZH
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAKULYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-717-7711
Mailing Address - Street 1:11249 LONESOME VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:LEONA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93551-7608
Mailing Address - Country:US
Mailing Address - Phone:626-922-6653
Mailing Address - Fax:
Practice Address - Street 1:11249 LONESOME VALLEY RD
Practice Address - Street 2:
Practice Address - City:LEONA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93551-7608
Practice Address - Country:US
Practice Address - Phone:213-465-6113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-05
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility