Organization
KLEAN W. HOLLYWOOD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARRYL BOOTH (DIRECTOR OF OPERATIONS)
(310) 922-2264
Entity
Organization
Contact information
Practice address
842 HILLDALE AVE, WEST HOLLYWOOD, CA 90069-4940
(310) 492-9820
Mailing address
8543 SANTA MONICA BLVD, WEST HOLLYWOOD, CA 90069-4150
(310) 492-9820
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190692FP
CA
Other
Enumeration date
03/15/2011
Last updated
03/15/2011
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