Provider Demographics
NPI:1083440804
Name:INNER LIGHT RECOVERY LLC
Entity type:Organization
Organization Name:INNER LIGHT RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ARKADI
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLOIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-434-1414
Mailing Address - Street 1:4321 CLEAR VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-3317
Mailing Address - Country:US
Mailing Address - Phone:818-434-1414
Mailing Address - Fax:
Practice Address - Street 1:4321 CLEAR VALLEY DR
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-3317
Practice Address - Country:US
Practice Address - Phone:818-434-1414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder