Provider Demographics
NPI:1902692767
Name:RADWOOD REHAB CENTER LLC
Entity type:Organization
Organization Name:RADWOOD REHAB CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AKOP
Authorized Official - Middle Name:REHAB CENTER
Authorized Official - Last Name:KESABLYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-635-7098
Mailing Address - Street 1:14144 VENTURA BLVD STE 280
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2769
Mailing Address - Country:US
Mailing Address - Phone:818-635-7098
Mailing Address - Fax:
Practice Address - Street 1:14144 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2739
Practice Address - Country:US
Practice Address - Phone:818-635-7098
Practice Address - Fax:818-635-7098
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RADWOOD REHAB CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-04-17
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder