Organization
LOST SHEEP, LLC
Active
Other names
Rebos Detox
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROSS REMIEN (CEO)
(310) 694-5590
Entity
Organization
Contact information
Practice address
4198 SUNSWEPT DRIVE, LOS ANGELES, CA 91604
(310) 694-5590
Mailing address
4198 SUNSWEPT DRIVE, LOS ANGELES, CA 91604
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190984AP
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190984AP
STATE LICENSE
CA
Enumeration date
09/15/2017
Last updated
09/15/2017
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