Provider Demographics
NPI:1407661713
Name:RECOVERY DYNAMICS LLC
Entity type:Organization
Organization Name:RECOVERY DYNAMICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:REZA
Authorized Official - Middle Name:
Authorized Official - Last Name:FARAZMAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-266-7484
Mailing Address - Street 1:1776 N HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-4404
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:948 S COCHRAN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4739
Practice Address - Country:US
Practice Address - Phone:213-333-3869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RECOVERY DYNAMICS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility