Organization
KLEAN W. HOLLYWOOD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRYL BOOTH (DIRECTOR OF OPERATIONS)
(310) 492-9824
Entity
Organization
Contact information
Practice address
852 HILLDALE AVE, ,852 1/2, 854 HILLDALE AVE, WEST HOLLYWOOD, CA 90069-4915
(310) 492-9824
Mailing address
8543 SANTA MONICA BLVD, SUITE 11, W HOLLYWOOD, CA 90069-4150
(310) 492-9824
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190692EP
CA
Other
Enumeration date
03/15/2011
Last updated
03/15/2011
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