Organization
GIFT OF LIFE RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDGAR SHAKHPAZYAN (PRESIDENT)
(818) 605-2299
Entity
Organization
Contact information
Practice address
2626 FOOTHILL BLVD STE 260, LA CRESCENTA, CA 91214-3569
(818) 605-2299
Mailing address
2626 FOOTHILL BLVD # 260, LA CRESCENTA, CA 91214-3569
(818) 605-2299
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/08/2024
Last updated
09/16/2024
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