Lifesync Recovery and Detoxification, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

190920AP Issued in CA

Legal business name

LIFESYNC RECOVERY AND DETOXIFICATION, LLC

Practice address

28632 Roadside Dr
Suite 235
Agoura Hills, CA 91301-6064

Phone

(310) 951-6340

NPI assigned

Aug 2, 2016

Organization subpart

No

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

Authorized official

Name

Geoffrey A Booth, MD

Title

Owner

Phone

(310) 951-6340

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470096000000",
    "number": "1730632159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6035 MURPHY WAY",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902654490",
            "telephone_number": "310-951-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28632 ROADSIDE DR",
            "address_2": "SUITE 235",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913016064",
            "telephone_number": "310-951-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESYNC RECOVERY AND DETOXIFICATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-02",
        "last_updated": "2016-08-02",
        "status": "A",
        "authorized_official_last_name": "BOOTH",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-951-6340",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190920AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noah Levine, PT, DPT
• Christopher Everett Levy, MD
• Ileane G Lew, LMFT
• En-En Huang Liao, AC
• Jessica Licht
• Timbrey Lind, RDH
• Ling Zhu, D.D.S., Inc.
• Changrui Liu
• Patrick Michael Lockwood, PSYD
• Liberty Rose Logan

• Substance Abuse Rehabilitation Facility in Agoura Hills, CA
• Providers in Agoura Hills, 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 Aug 2, 2016; 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.