Provider Demographics
NPI:1972317964
Name:A AND A DETOX CENTER
Entity type:Organization
Organization Name:A AND A DETOX CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:AGHEKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-318-0202
Mailing Address - Street 1:16806 ADDISON ST
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-1054
Mailing Address - Country:US
Mailing Address - Phone:818-318-0202
Mailing Address - Fax:
Practice Address - Street 1:16806 ADDISON ST
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-1054
Practice Address - Country:US
Practice Address - Phone:818-318-0202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility