MEDICARE: CHANDLER TREATMENT LLC

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
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1649879768
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHANDLER TREATMENT LLC

Provider Business Mailing Address
First Line	:	5503 CAHUENGA BLVD STE 101
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-2944
Country	:	US
Telephone Number	:	818-358-2789
Fax Number	:

Provider Business Practice Location Address
First Line	:	5503 CAHUENGA BLVD STE 101
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-2944
Country	:	US
Telephone Number	:	818-358-2789
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	STANLEY NADER
Credential	:
Telephone Number	:	310-913-5418

Provider Enumeration Date	:	10/20/2020
Last Update Date	:	01/24/2024

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Directions to “CHANDLER TREATMENT LLC ” Practice Location

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