Organization
MARIPOSA DETOX CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDAN FREEMAN (CEO)
(631) 245-0911
Entity
Organization
Contact information
Practice address
832 N MARIPOSA AVE, LOS ANGELES, CA 90029-3405
(561) 563-6582
Mailing address
832 N MARIPOSA AVE, LOS ANGELES, CA 90029-3405
(561) 563-6582
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
05/12/2020
Last updated
10/22/2020
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