TARZANA TREATMENT CENTERS, INC (NPI# 1003219775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003219775 |
| Entity Type | Organization |
| Organization Name | TARZANA TREATMENT CENTERS, INC |
| Other Organization Name | TARZANA TREATMENT CENTERS FAMILY MEDICAL GRANADA HILLS CLINI |
| Practice Address |
10605 Balboa Blvd Granada Hills CA 91344-6342 |
| Mailing Address |
18646 Oxnard St Tarzana CA 91356-1411 |
| Practice Telephone | 8186543815 |
| Mailing Telephone | 8189961051 |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2017-05-04 |
| Authorized Official Name | ALBERT SENELLA (PRESIDENT/CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 8186543815 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Tarzana Treatment Centers Family Medical Granada Hills Clini | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477031144 | Tarzana Treatment Centers, Inc | Community/Behavioral Health | 6018 Variel Ave, Woodland Hills, CA 91367-3719 | 2018-08-03 |
| 1285175315 | Tarzana Treatment Centers, Inc | Substance Abuse Rehabilitation Facility | 44505 90th St W, Lancaster, CA 93536-7705 | 2017-03-08 |
| 1396223103 | Tarzana Treatment Centers, Inc | Community/Behavioral Health | 6022 Variel Ave, Woodland Hills, CA 91367-3719 | 2018-08-02 |
| 1285008938 | Tarzana Treatment Centers, Inc | Clinic/Center | 14660 Oxnard St, Van Nuys, CA 91411-3119 | 2015-11-18 |
| Street Address |
10605 BALBOA BLVD |
| City | GRANADA HILLS |
| State | CA |
| Zip Code | 91344-6342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982619359 | Vinod M Assomull Sr. | Internal Medicine | 10605 Balboa Blvd, 240, Granada Hills, CA 91344-6342 | 2006-07-31 |
| 1578099008 | Laveita Clay | Counselor | 10605 Balboa Blvd, #100, Granada Hills, CA 91344-6342 | 2017-05-03 |
| 1366989980 | Arineh Ebrahimi | Counselor | 10605 Balboa Blvd, Suit # 100, Granada Hills, CA 91344-6342 | 2017-01-20 |
| 1619428174 | Jichelle Cataquiz Bandoquillo | Physical Therapist | 10605 Balboa Blvd, Granada Hills, CA 91344-6342 | 2016-10-20 |
| 1306393368 | Mary Panosian | Psychologist | 10605 Balboa Blvd, #100, Granada Hills, CA 91344-6342 | 2016-09-07 |
| 1134676141 | Peter Karinen | Community/Behavioral Health | 10605 Balboa Blvd, Suite 100, Granada Hills, CA 91344-6342 | 2016-09-07 |
| 1508313073 | Nashua Souza | Case Manager/Care Coordinator | 10605 Balboa Blvd, Suite 100, Granada Hills, CA 91344-6342 | 2016-09-01 |
| 1487009916 | Carlos Paul Duarte II | Social Worker | 10605 Balboa Blvd, Suite 100, Granada Hills, CA 91344-6342 | 2016-05-03 |
| 1013376698 | Aei & Associates | Clinic/Center | 10605 Balboa Blvd, Granada Hills, CA 91344-6342 | 2016-02-11 |
| 1023477627 | Washington & Associates | Durable Medical Equipment & Medical Supplies | 10605 Balboa Blvd, Granada Hills, CA 91344-6342 | 2016-02-11 |
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| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| City | GRANADA HILLS |
| Zip Code | 91344 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.