Organization
GEVS RECOVERY CENTER
Active
Other names
Milestone Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STANISLAV KOLBASOV (CEO, CFO, SECRETARY)
(949) 212-8114
Entity
Organization
Contact information
Practice address
19448 LASSEN ST, NORTHRIDGE, CA 91324-1121
(949) 212-8114
Mailing address
19448 LASSEN ST, NORTHRIDGE, CA 91324-1121
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
05/25/2023
Last updated
07/08/2023
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