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Organization
WESTLAKE REVIVE
Active
Organization
WESTLAKE REVIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA ANDERSON (ADMINISTRATOR)
(805) 286-1180
Entity
Organization
Contact information
Practice address
227 W JANSS RD STE 350, THOUSAND OAKS, CA 91360
(805) 286-1180
Mailing address
1014 S WESTLAKE BLVD # 14-289, WESTLAKE VILLAGE, CA 91361-3108
(805) 286-1180
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
06/14/2018
Last updated
07/05/2018
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