Provider Demographics
NPI:1053192849
Name:HIGHERVISION GH INC
Entity type:Organization
Organization Name:HIGHERVISION GH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:GHARIBIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-926-6468
Mailing Address - Street 1:3278 DORA VERDUGO DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-1755
Mailing Address - Country:US
Mailing Address - Phone:818-926-6468
Mailing Address - Fax:
Practice Address - Street 1:3278 DORA VERDUGO DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-1755
Practice Address - Country:US
Practice Address - Phone:818-926-6468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder