Organization
INNOVATE RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANA KESARYAN (CEO)
(818) 523-0025
Entity
Organization
Contact information
Practice address
14718 KESWICK ST, VAN NUYS, CA 91405-1205
(818) 523-0025
Mailing address
14718 KESWICK ST, VAN NUYS, CA 91405-1205
(818) 523-0025
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
08/29/2023
Last updated
12/14/2023
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