Organization · Type 2 NPI

Executive Recovery Group, Inc

Substance Abuse Rehabilitation Facility · Tarzana, CA

NPI number 1972169605 Active

Practice location

4755 Amigo Ave
Tarzana, CA 91356-4501

Call (760) 409-1287 Map

Mailing address

203 S Orange Dr
Los Angeles, CA 90036-3010

Specialties and licenses

Taxonomy	Code	License
Mental Health Clinic/Center (Including Community Mental Health Center)	261QM0801X	None listed
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.

Another provider at this address

Executive Recovery Group, IncMental Illness Community Based Residential Treatment Facility Tarzana, CA NPI 1679273908

Other substance abuse rehabilitation facility providers in Tarzana

See all in Tarzana →

NPI record

NPI: 1972169605
Entity type: Organization (Type 2)
Issued: May 17, 2019
Last updated: Feb 10, 2022
Status: Active
Subpart: Yes of Executive Recovery Group, Inc

Other names

<unavail>
Renewal Health Group · doing business as
Sanctuary Amgio · doing business as

Authorized official

Amy Crichton
Executive Director
(760) 200-3839

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1972169605

Executive Recovery Group, Inc's National Provider Identifier is 1972169605, issued on May 17, 2019. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Tarzana, CA. The record was last updated on Feb 10, 2022.