Organization
CHABAD OF CALIFORNIA
Active
Other names
Chabad Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID KOVI BLAUNER (ADMINISTRATOR)
(323) 965-1365
Entity
Organization
Contact information
Practice address
1750 S LA CIENEGA BLVD, LOS ANGELES, CA 90035-4602
(323) 965-1365
Mailing address
1750 S LA CIENEGA BLVD, LOS ANGELES, CA 90035-4602
(323) 965-1365
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
190087DN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190087DN
STATE LICENSE
CA
Enumeration date
07/19/2016
Last updated
07/19/2016
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