<Unavail>

LBN: Executive Recovery Group, Inc
<Unavail> is an health care organization with primary practice located at 4755 Amigo Ave , Tarzana CA 91356-4501. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Residential Treatment Facilities / Substance Abuse Rehabilitation Facility. Residential Treatment Facilities / Substance Abuse Rehabilitation Facility is the primary health care specialty. Executive Recovery Group, Inc can be contacted via phone (760) 409-1287, or through Crichton, Amy via phone (760) 200-3839.

Contact Information

Primary practice address
4755 Amigo Ave Tarzana CA 91356-4501
Phone: (760) 409-1287
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Crichton, Amy
Phone: (760) 200-3839

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X

Profile Details

NPI number 1972169605
LBN Legal business name Executive Recovery Group, Inc
DBA Doing business as <Unavail>
Authorized official Crichton, Amy
Entity Organization
Organization subpart 1 Yes
Enumeration date May 17th, 2019
Last updated Feb 10th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972169605 NPPES
California Other 190042BP DEPARTMENT OF HEALTH CARE SERVICES

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