| Asc Treatment Group | |
|
5335 Craner Ave North Hollywood CA 91601-3313 | |
| (626) 872-6632 | |
| Not Available |
| Full Name | Asc Treatment Group |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5335 Craner Ave, North Hollywood, California |
| Authorized Official Name and Position | Donetta Jackson (ADMINISTRATOR) |
| Authorized Official Contact | 3233182520 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Asc Treatment Group 2457 Endicott St Los Angeles CA 90032-3047 Ph: (323) 227-5252 | Asc Treatment Group 5335 Craner Ave North Hollywood CA 91601-3313 Ph: (626) 872-6632 |
| NPI Number | 1003942970 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 08/28/2020 |
| Certification Date | 08/28/2020 |
| Medicare PECOS PAC ID | 8527121375 |
|---|---|
| Medicare Enrollment ID | O20090106000387 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003942970 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MFC38512 (California) | Primary |
| Provider Name | Alan Markie |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861475337 PECOS PAC ID: 8123086857 Enrollment ID: I20041228000990 |
| Provider Name | Michael D Rosberg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700926474 PECOS PAC ID: 1850384256 Enrollment ID: I20140613001960 |
| Provider Name | Chess Brodnick |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1851431589 PECOS PAC ID: 3173686946 Enrollment ID: I20241028002926 |
| Provider Name | Ken Bagnis |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1750418653 PECOS PAC ID: 1557896446 Enrollment ID: I20241202002654 |
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