Provider Demographics
NPI:1356176440
Name:ZIKA RECOVERY LLC
Entity type:Organization
Organization Name:ZIKA RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:
Authorized Official - Last Name:TER-HOVHANNISYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-928-0026
Mailing Address - Street 1:5850 CANOGA AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6750
Mailing Address - Country:US
Mailing Address - Phone:818-928-0026
Mailing Address - Fax:
Practice Address - Street 1:3170 S GILBERT RD STE 2
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-5104
Practice Address - Country:US
Practice Address - Phone:818-928-0026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility