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Organization
BOLD RECOVERY, INC.
Active
Organization
BOLD RECOVERY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN JOHNSON LMFT (PROGRAM DIRECTOR)
(213) 327-4209
Entity
Organization
Contact information
Practice address
3407 W 6TH ST STE 700, LOS ANGELES, CA 90020-2512
(213) 263-9549
Mailing address
3407 W 6TH ST STE 700, LOS ANGELES, CA 90020-2512
(213) 263-9549
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/19/2023
Last updated
09/19/2023
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