Organization · Type 2 NPI
11821 Foothill BLVD
Addiction (Substance Use Disorder) Counselor · Los Angeles, CA
NPI number
1164767356
Active
Practice location
5436 S. Broadway
Los Angeles, CA 90037
Mailing address
11821 Foothill Blvd # K35
Lake View Terrace, CA 91342-7200
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | None listed |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1164767356
11821 Foothill BLVD's National Provider Identifier is 1164767356, issued on Nov 29, 2012. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Los Angeles, CA. The record was last updated on Nov 29, 2012.