Organization
AXIS RESIDENTIAL TREATMENT - WEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRAD KEITH CADAC (CEO/OWNER)
(310) 435-6298
Entity
Organization
Contact information
Practice address
4024 HURON AVE, CULVER CITY, CA 90232-4017
(310) 838-3640
Mailing address
4024 HURON AVE, CULVER CITY, CA 90232-4017
(310) 838-3640
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190727AP
CA
Other
Enumeration date
02/29/2012
Last updated
02/29/2012
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