# VICI PERFORMANCE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396478707
- **Authorized official:** RAUL MIRANDA (FOUNDER)
- **Authorized official phone:** (805) 760-2700

## Contact information

- **Practice address:** 28631 CANWOOD ST, AGOURA HILLS, CA 91301-3213
- **Practice address phone:** (818) 923-7555
- **Mailing address:** 28631 CANWOOD ST, AGOURA HILLS, CA 91301-3213
- **Mailing address phone:** (818) 923-7555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0800X | Recovery Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/03/2022
- **Last updated:** 07/10/2022