Healthcare Provider Details

I. General information

NPI: 1851216196
Provider Name (Legal Business Name): WELLTANA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13502 KITTRIDGE ST
VAN NUYS CA
91401-1109
US

IV. Provider business mailing address

13502 KITTRIDGE ST
VAN NUYS CA
91401-1109
US

V. Phone/Fax

Practice location:
  • Phone: 818-461-4980
  • Fax:
Mailing address:
  • Phone: 818-461-4980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDO SARKISYAN
Title or Position: CEO
Credential:
Phone: 818-461-4980