Organization
RISE LUXURY REHAB, LLC
Active
Other names
Rise in Malibu
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK MITCHELL (CEO)
(310) 807-4379
Entity
Organization
Contact information
Practice address
1950 ROCKING HORSE DR, SIMI VALLEY, CA 93065-5906
(424) 313-5108
(310) 807-4379
Mailing address
1310 WESTWOOD BLVD, LOS ANGELES, CA 90024-4902
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
560011AP
CA STATE LICENSE NUMBER
CA
Enumeration date
12/04/2018
Last updated
12/04/2018
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