Organization
SOCAL TRANSITIONAL LIVING LLC
Active
Other names
Purposes Recovery
Organization subpart
No
Provider details
NPI number
Authorized official
MARK RIZKALLAH (CEO)
(818) 926-1982
Entity
Organization
Contact information
Practice address
7239 KENTWOOD AVE, LOS ANGELES, CA 90045-1255
(800) 300-2026
Mailing address
7239 KENTWOOD AVE, LOS ANGELES, CA 90045-1255
(818) 926-1982
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
07/21/2021
Last updated
10/03/2022
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