Organization
CASA BELLA SOBER LIVING - WEST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FIONA A RAY LMFT (CO-OWNER/OPERATOR)
(310) 913-0029
Entity
Organization
Contact information
Practice address
1937 FEDERAL AVE, LOS ANGELES, CA 90025-5415
(310) 913-0029
(310) 913-0029
Mailing address
PO BOX 12410, MARINA DEL REY, CA 90295-3410
(310) 913-0029
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190937AP
CA
Other
Enumeration date
06/29/2017
Last updated
06/29/2017
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