Organization
KLEAN W. HOLLYWOOD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARRYL BOOTH (DIRECTOR OF OPERATIONS)
(310) 492-9820
Entity
Organization
Contact information
Practice address
850 HILLDALE AVE, WEST HOLLYWOOD, CA 90069-4907
(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
190692GP
CA
Other
Enumeration date
03/15/2011
Last updated
03/15/2011
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