Lifehouse Recovery Av, Inc

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

LIFEHOUSE RECOVERY AV, INC

Practice address

41642 Sherry Way
Palmdale, CA 93551-1684

Phone

(661) 206-5285

NPI assigned

Oct 13, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Ganello

Title

Administrator

Phone

(323) 872-8721

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1697155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1003697137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41642 SHERRY WAY",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41642 SHERRY WAY",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511684",
            "telephone_number": "661-206-5285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEHOUSE RECOVERY AV, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-13",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A",
        "authorized_official_last_name": "GANELLO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "323-872-8721"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Palmdale, CA
• Providers in Palmdale, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.