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NPI Code Detail

MEDICARE: EMULATE TREATMENT CENTER, INC

MEDICARE: EMULATE TREATMENT CENTER, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0850XAdult Mental Health Clinic/Center
2261QR0401XComprehensive Outpatient Rehabilitation Facility (CORF)

General Provider Information

NPI Number : 1538943972
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMULATE TREATMENT CENTER, INC
Provider Business Mailing Address
First Line : 5999 TOPANGA CANYON BLVD
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-3623
Country : US
Telephone Number : 818-808-0108
Fax Number :
Provider Business Practice Location Address
First Line : 5999 TOPANGA CANYON BLVD
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-3623
Country : US
Telephone Number : 818-808-0108
Fax Number : 818-337-2003
Authorized Official
Title or Position : CEO
Name : MR. ISHKHAN SHAHAZIYAN
Credential :
Telephone Number : 818-808-0108
Provider Enumeration Date : 08/24/2023
Last Update Date : 10/04/2024

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Directions to “EMULATE TREATMENT CENTER, INC ” Practice Location

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