Organization · Type 2 NPI

La Fuente Hollywood Treatment Center LLC

Substance Abuse Rehabilitation Facility · Los Angeles, CA

NPI number 1083101661 Active

Practice location

1601 N Gower St # 101
Los Angeles, CA 90028-7596

Call (323) 464-2947 Map

Mailing address

5718 Fountain Ave
Los Angeles, CA 90028-8516

Specialties and licenses

Taxonomy	Code	License
Substance Abuse Rehabilitation Facility Primary	324500000X	None listed

Substance Abuse Rehabilitation Facility: A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

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NPI record

NPI: 1083101661
Entity type: Organization (Type 2)
Issued: Apr 18, 2018
Last updated: Apr 18, 2018
Status: Active
Subpart: Yes of La Fuente Hollywood Treatment Center LLC

Other names

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La Fuente Hollywood Treatment Center Outpatient · doing business as
La Fuente Hollywood Treatment Center Outpatient · doing business as

Authorized official

Manuel Rodriguez
CEO
(323) 464-2947

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About NPI 1083101661

La Fuente Hollywood Treatment Center LLC's National Provider Identifier is 1083101661, issued on Apr 18, 2018. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Los Angeles, CA. The record was last updated on Apr 18, 2018.