Provider Demographics
NPI:1194438960
Name:88'S REHAB LLC
Entity type:Organization
Organization Name:88'S REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDUARD
Authorized Official - Middle Name:GABRIEL
Authorized Official - Last Name:GABRIELYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-749-1060
Mailing Address - Street 1:2912 N MYERS ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-1730
Mailing Address - Country:US
Mailing Address - Phone:818-939-9056
Mailing Address - Fax:
Practice Address - Street 1:2912 N MYERS ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-1730
Practice Address - Country:US
Practice Address - Phone:818-939-9056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-27
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility