Organization
MY LIFE RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PENNY KOPIT BADLERMOCK (CEO)
(747) 361-5154
Entity
Organization
Contact information
Practice address
8431 SHIRLEY AVE, NORTHRIDGE, CA 91324-4148
(747) 361-5154
Mailing address
8431 SHIRLEY AVE, NORTHRIDGE, CA 91324-4148
(747) 361-5154
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/08/2024
Last updated
02/10/2026
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