Organization
LA FUENTE HOLLYWOOD TREATMENT CENTER LLC
Active
Parent organization
LA FUENTE HOLLYWOOD TREATMENT CENTER LLC
Other names
La Fuente Hollywood Treatment Center Outpatient
Organization subpart
Yes
Provider details
NPI number
Legal business name
LA FUENTE HOLLYWOOD TREATMENT CENTER LLC
Authorized official
MANUEL RODRIGUEZ (CEO)
(323) 464-2947
Entity
Organization
Contact information
Practice address
1601 N GOWER ST # 101, LOS ANGELES, CA 90028-7596
(323) 464-2947
Mailing address
5718 FOUNTAIN AVE, LOS ANGELES, CA 90028-8516
(323) 464-2947
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
04/18/2018
Last updated
04/18/2018
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