Healthcare Provider Details

I. General information

NPI: 1205011582
Provider Name (Legal Business Name): TFSC-ENCINO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2008
Last Update Date: 01/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16260 VENTURA BLVD STE 309
ENCINO CA
91436-2276
US

IV. Provider business mailing address

13741 FOOTHILL BLVD STE 270
SYLMAR CA
91342-3150
US

V. Phone/Fax

Practice location:
  • Phone: 818-906-7643
  • Fax: 818-906-7641
Mailing address:
  • Phone: 818-833-9789
  • Fax: 818-833-9790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: OLGA SKARLATO
Title or Position: CEO
Credential: PHD
Phone: 818-833-9789