| |
14558 Sylvan St. Van Nuys CA 91411-2613 | |
(818) 787-4151 | |
(818) 787-2840 |
Full Name | |
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Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 14558 Sylvan St., Van Nuys, California |
Authorized Official Name and Position | Elizabeth J Macias (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 8187874151 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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15015 Oxnard St. Van Nuys CA 91411-2613 Ph: (818) 787-4151 | 14558 Sylvan St. Van Nuys CA 91411-2613 Ph: (818) 787-4151 |
NPI Number | 1780837021 |
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Provider Enumeration Date | 10/30/2008 |
Last Update Date | 12/05/2008 |
Identifier | Type | State | Issuer |
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1780837021 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YA0400X | Counselor - Addiction (substance Use Disorder) | 190327AP (California) | Primary |
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