Provider Demographics
NPI:1497548978
Name:AGOURA RECOVERY COMMUNITY, INC.
Entity type:Organization
Organization Name:AGOURA RECOVERY COMMUNITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RILEY
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:661-600-5245
Mailing Address - Street 1:29219 CANWOOD ST # 108
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-1560
Mailing Address - Country:US
Mailing Address - Phone:661-600-5245
Mailing Address - Fax:
Practice Address - Street 1:29219 CANWOOD ST # 108
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-1560
Practice Address - Country:US
Practice Address - Phone:661-600-5245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health