Provider Demographics
NPI:1174882930
Name:NEW CHOICE RECOVERY TREATMENT CENTER, INC.
Entity type:Organization
Organization Name:NEW CHOICE RECOVERY TREATMENT CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SEMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-307-5492
Mailing Address - Street 1:5436 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-4126
Mailing Address - Country:US
Mailing Address - Phone:323-234-6261
Mailing Address - Fax:323-234-6265
Practice Address - Street 1:18107 SHERMAN WAY STE 203
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-8802
Practice Address - Country:US
Practice Address - Phone:323-234-6261
Practice Address - Fax:323-234-6265
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW CHOICE RECOVERY TREATMENT CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-14
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190597AP251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health