Organization · Type 2 NPI
Independence Community Treatment Clinic
Community Health Clinic/Center · Littlerock, CA
NPI number
1134366115
Active
Practice location
10833 E Avenue R, Room 118, 119, 217
Littlerock, CA 93543-4106
Mailing address
19231 Victory Blvd, Suite 554
Reseda, CA 91335-6308
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Community Health Clinic/Center Primary | 261QC1500X | 960001358 (CA) |
Community Health Clinic/Center: Definition to come...
Another provider at this address
About NPI 1134366115
Independence Community Treatment Clinic's National Provider Identifier is 1134366115, issued on Jan 14, 2009. The primary taxonomy on file is Community Health Clinic/Center (261QC1500X), and the practice location is in Littlerock, CA. The record was last updated on Dec 18, 2009.