Provider Demographics
NPI:1144003468
Name:DIGNITY DETOX CENTER
Entity type:Organization
Organization Name:DIGNITY DETOX CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTUR
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIROSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-429-0323
Mailing Address - Street 1:412 WESTLAKE DR
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-7972
Mailing Address - Country:US
Mailing Address - Phone:818-429-0323
Mailing Address - Fax:877-671-2202
Practice Address - Street 1:412 WESTLAKE DR
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-7972
Practice Address - Country:US
Practice Address - Phone:818-429-0323
Practice Address - Fax:877-671-2202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder