Organization
LA FUENTE HOLLYWOOD TREATMENT CENTER LLC
Active
Other names
La Fuente Hollywood Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL RODRIGUEZ (EXECUTIVE DIRECTOR)
(323) 464-2947
Entity
Organization
Contact information
Practice address
5718 FOUNTAIN AVE, LOS ANGELES, CA 90028-8516
(323) 464-2947
(323) 366-9339
Mailing address
5718 FOUNTAIN AVE, LOS ANGELES, CA 90028-8516
(323) 464-2947
(323) 366-9339
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190725AP
CA
Other
Enumeration date
03/05/2012
Last updated
03/05/2012
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