Provider Demographics
NPI:1053516567
Name:KB RECOVERY INC.
Entity type:Organization
Organization Name:KB RECOVERY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BABAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:818-891-3639
Mailing Address - Street 1:15722 TUPPER ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-3124
Mailing Address - Country:US
Mailing Address - Phone:818-891-3639
Mailing Address - Fax:818-892-9471
Practice Address - Street 1:15722 TUPPER ST
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-3124
Practice Address - Country:US
Practice Address - Phone:818-891-3639
Practice Address - Fax:818-892-9471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190527AP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility