Organization
PHOENIX HOUSES OF LOS ANGELES, INC.
Active
Other names
Phoenix Academy at Lake View Terrace
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHAWNA RENEE MORRIS (SENIOR VICE PRESIDENT AND EXECUTIVE)
(818) 686-3011
Entity
Organization
Contact information
Practice address
11600 ELDRIDGE AVE, LAKE VIEW TERRACE, CA 91342-6506
(818) 686-3000
(818) 896-4859
Mailing address
11600 ELDRIDGE AVE, LAKE VIEW TERRACE, CA 91342-6506
(818) 686-3000
(818) 686-3016
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190115BN
CA
3245S0500X
Children's Substance Abuse Rehabilitation Facility
191222731
CA
Other
Enumeration date
01/11/2017
Last updated
04/23/2018
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