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 (CHIEF ADMINISTRATIVE OFFICER)
(707) 879-8432
Entity
Organization
Contact information
Practice address
1506 RONNE DR, SANTA ROSA, CA 95404-5705
(707) 879-8432
(844) 426-0134
Mailing address
130 STONY POINT RD STE J, SANTA ROSA, CA 95401-4120
(707) 879-8432
(844) 426-0134
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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