Organization
O/G RECOVERY
Active
Other names
Grace Recovery Community
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY ADAM HOLDEN (PRESIDENT)
(310) 499-3112
Entity
Organization
Contact information
Practice address
6078 SELMA AVE, LOS ANGELES, CA 90028-6415
(310) 499-3112
Mailing address
12801 MILBANK ST, STUDIO CITY, CA 91604-1354
(310) 499-3112
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
08/05/2018
Last updated
08/05/2018
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