Healthcare Provider Details

I. General information

NPI: 1336500248
Provider Name (Legal Business Name): OGA HEALTH PARTNERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2016
Last Update Date: 03/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 LUNDY DR
SIMI VALLEY CA
93065-4232
US

IV. Provider business mailing address

1116 LUNDY DR
SIMI VALLEY CA
93065-4232
US

V. Phone/Fax

Practice location:
  • Phone: 323-428-4258
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: GALINA BLANK
Title or Position: OWNER
Credential:
Phone: 323-428-4258