Organization
PURA VIDA RECOVERY SERVICES, LLC
Active
Other names
Pura Vida Recovery Services
Organization subpart
No
Provider details
NPI number
Authorized official
BEN A PAHLAVAN (CAO)
(707) 879-8432
Entity
Organization
Contact information
Practice address
2901 CLEVELAND AVE STE 101&103, SANTA ROSA, CA 95403-2785
(707) 879-8432
(844) 426-0134
Mailing address
2901 CLEVELAND AVE STE 103, SANTA ROSA, CA 95403-2788
(707) 879-8432
(844) 426-0134
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
10/22/2024
Last updated
10/29/2024
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