Organization
5 FIVE STAR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HRACHUHI CHRISTINE PETIKYAN (CEO)
(747) 877-0003
Entity
Organization
Contact information
Practice address
8230 ALLOTT AVE, PANORAMA CITY, CA 91402-5502
(650) 483-9547
Mailing address
8230 ALLOTT AVE, VAN NUYS, CA 91402-5502
(747) 247-2027
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
08/23/2022
Last updated
01/11/2024
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