Organization
LIFEHOUSE RECOVERY AV, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GANELLO (ADMINISTRATOR)
(323) 872-8721
Entity
Organization
Contact information
Practice address
41642 SHERRY WAY, PALMDALE, CA 93551-1684
(661) 206-5285
Mailing address
41642 SHERRY WAY, PALMDALE, CA 93551-1684
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/13/2023
Last updated
12/16/2024
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