Organization
5 RES DETOX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEXIE SHINE (CEO)
(213) 944-9468
Entity
Organization
Contact information
Practice address
10902 RIVERSIDE DR #B, NORTH HOLLYWOOD, CA 91682
(213) 944-9468
Mailing address
10902 RIVERSIDE DR #B, NORTH HOLLYWOOD, CA 91682
(213) 944-9468
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
09/29/2016
Last updated
04/26/2017
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