Organization
4 PILLARS DETOX CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN AUSTIN (COMPLIANCE OFFICER)
(818) 915-5668
Entity
Organization
Contact information
Practice address
17238 VALERIO ST, LAKE BALBOA, CA 91406-2505
(818) 687-0059
Mailing address
17238 VALERIO ST, LAKE BALBOA, CA 91406-2505
(818) 687-0059
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
08/15/2024
Last updated
08/15/2024
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