Organization
LIFESYNC RECOVERY AND DETOXIFICATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY A BOOTH MD (OWNER)
(310) 951-6340
Entity
Organization
Contact information
Practice address
28632 ROADSIDE DR, SUITE 235, AGOURA HILLS, CA 91301-6064
(310) 951-6340
Mailing address
6035 MURPHY WAY, MALIBU, CA 90265-4490
(310) 951-6340
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190920AP
CA
Other
Enumeration date
08/02/2016
Last updated
08/02/2016
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