Organization
SOBER DISTRICT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIGRAN MAMIKONYAN (CEO)
(818) 859-3568
Entity
Organization
Contact information
Practice address
6628 VAN NUYS BLVD, VAN NUYS, CA 91405-4617
(213) 364-8065
Mailing address
6628 VAN NUYS BLVD, VAN NUYS, CA 91405-4617
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
CA
Other
Enumeration date
03/31/2018
Last updated
10/31/2018
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