Glendale Luxury Rehab LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

GLENDALE LUXURY REHAB LLC

Practice address

742 Cavanagh Rd
Glendale, CA 91207-1412

Phone

(310) 880-2334

NPI assigned

Apr 21, 2023

Organization subpart

No

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

Authorized official

Name

Lusine Avetisyan

Title

Ceo

Phone

(310) 880-2334

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682035200000",
    "number": "1760179329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 CAVANAGH RD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912071412",
            "telephone_number": "310-880-2334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 CAVANAGH RD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912071412",
            "telephone_number": "310-880-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE LUXURY REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-21",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A",
        "authorized_official_last_name": "AVETISYAN",
        "authorized_official_first_name": "LUSINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-880-2334"
    },
    "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 Glendale, CA
• Providers in Glendale, 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 Apr 21, 2023; 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.