Organization
WARNER PARK RECOVERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GENNADIY KOPYTOV (MEMBER)
(310) 927-7532
Entity
Organization
Contact information
Practice address
22011 VENTURA BLVD, WOODLAND HILLS, CA 91364-1646
(310) 927-7532
Mailing address
22011 VENTURA BLVD, WOODLAND HILLS, CA 91364-1646
(323) 578-7602
(818) 709-0606
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
05/01/2018
Last updated
07/29/2024
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