Organization · Type 2 NPI
Independence Community Treatment Clinic
Community Health Clinic/Center · Lancaster, CA
NPI number
1396990685
Active
Practice location
3200 E Avenue J8, Room 101,102,103,104,121,124
Lancaster, CA 93535-5827
Fax (818) 776-1657
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...
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About NPI 1396990685
Independence Community Treatment Clinic's National Provider Identifier is 1396990685, issued on Dec 1, 2008. The primary taxonomy on file is Community Health Clinic/Center (261QC1500X), and the practice location is in Lancaster, CA. The record was last updated on Dec 11, 2009.