Organization · Type 2 NPI

Jack Gaines A Professional Corp.

Adult Mental Health Clinic/Center · Encino, CA

NPI number 1619210291 Active

Practice location

4833 Rubio Ave
Encino, CA 91436-1118

Call (818) 981-4030 Map

Specialties and licenses

TaxonomyCodeLicense
Adult Mental Health Clinic/Center Primary 261QM0850XC14269 (CA)

Adult Mental Health Clinic/Center: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

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About NPI 1619210291

Jack Gaines A Professional Corp.'s National Provider Identifier is 1619210291, issued on Apr 1, 2013. The primary taxonomy on file is Adult Mental Health Clinic/Center (261QM0850X), and the practice location is in Encino, CA. The record was last updated on Apr 1, 2013.