Organization
ORIGINS TREATMENT CENTER, LLC
Active
Other names
Create Recovery Center, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARRETT STANFORD (PARTNER)
(626) 590-0772
Entity
Organization
Contact information
Practice address
5300 BEETHOVEN ST, LOS ANGELES, CA 90066-7069
(310) 927-7532
Mailing address
5300 BEETHOVEN ST, LOS ANGELES, CA 90066-7069
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
05/23/2019
Last updated
09/17/2020
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