Organization
ADVANCE LIFE RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVIT KSACHIKYAN (CEO)
(888) 929-2891
Entity
Organization
Contact information
Practice address
9350 TAMPA AVE, NORTHRIDGE, CA 91324-2744
(888) 929-2891
(818) 483-9859
Mailing address
9350 TAMPA AVE, NORTHRIDGE, CA 91324-2744
(888) 929-2891
(818) 483-9859
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
07/11/2025
Last updated
07/11/2025
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