Organization · Type 2 NPI
Independence Community Treatment Clinic
Community Health Clinic/Center · Quartz Hill, CA
NPI number
1417192550
Active
Practice location
6040 W Avenue L, ROOM423,V3, Agi
Quartz Hill, CA 93536-4501
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...
Another provider at this address
About NPI 1417192550
Independence Community Treatment Clinic's National Provider Identifier is 1417192550, issued on Dec 3, 2008. The primary taxonomy on file is Community Health Clinic/Center (261QC1500X), and the practice location is in Quartz Hill, CA. The record was last updated on Dec 11, 2009.