Organization · Type 2 NPI

Independence Community Treatment Clinic

Community Health Clinic/Center · Palmdale, CA

NPI number 1205081593 Active

Practice location

39055 25th St W, ROOM426,427,428,429,430
Palmdale, CA 93551-4164

Call (818) 776-1755 Map

Fax (818) 776-1657

Mailing address

19231 Victory Blvd, Suite 554
Reseda, CA 91335-6308

Specialties and licenses

TaxonomyCodeLicense
Community Health Clinic/Center Primary 261QC1500X960001358 (CA)

Community Health Clinic/Center: Definition to come...

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About NPI 1205081593

Independence Community Treatment Clinic's National Provider Identifier is 1205081593, issued on Dec 1, 2008. The primary taxonomy on file is Community Health Clinic/Center (261QC1500X), and the practice location is in Palmdale, CA. The record was last updated on Dec 11, 2009.