Mystic Recovery, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

190091AP Issued in CA

Legal business name

MYSTIC RECOVERY, LLC

Practice address

22935 Ventura Blvd Ste 226
Woodland Hills, CA 91364-5824

Phone

(818) 231-3334

NPI assigned

Apr 25, 2018

Organization subpart

No

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

Authorized official

Name

Sarah Tawil

Title

Ceo

Phone

(818) 231-3334

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524614400000",
    "number": "1770071748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20335 PARTHENIA ST",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913061140",
            "telephone_number": "818-231-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22935 VENTURA BLVD STE 226",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913645824",
            "telephone_number": "818-231-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYSTIC RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-25",
        "last_updated": "2018-04-25",
        "status": "A",
        "authorized_official_last_name": "TAWIL",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-231-3334"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190091AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Mustin
• My Choice Ipa
• Howard Lee Myerhoff, PHD
• Kevin F. Myerly, MD
• Gordon S. Myers, MD
• Laura Marie Naas, MFT
• Jawai Nabau Stevens, NP
• Andrew Nadell, MFT
• Nader Ahdout D.D.S. Inc
• Bunichi Nagakawa, MD

• Substance Abuse Rehabilitation Facility in Woodland Hills, CA
• Providers in Woodland 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 Apr 25, 2018; 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.