Organization
IRIS HEALING RETREAT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELENA KAPUSTINA PSYD (CEO)
(323) 449-0016
Entity
Organization
Contact information
Practice address
5663 JUMILLA AVE, WOODLAND HILLS, CA 91367-6910
(323) 449-0016
(818) 301-1940
Mailing address
23033 OSTRONIC DR, WOODLAND HILLS, CA 91367-6143
(818) 436-2646
(818) 301-1940
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
07/28/2016
Last updated
10/28/2024
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