Healthcare Provider Details

I. General information

NPI: 1720254535
Provider Name (Legal Business Name): MOMENTUM AGENCIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2170 N WESTLAKE BLVD
WESTLAKE VILLAGE CA
91362-5122
US

IV. Provider business mailing address

9509 VASSAR AVE STE A
CHATSWORTH CA
91311-0883
US

V. Phone/Fax

Practice location:
  • Phone: 805-494-1141
  • Fax: 805-496-5823
Mailing address:
  • Phone: 818-782-2211
  • Fax: 818-350-1440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number550000649
License Number StateCA

VIII. Authorized Official

Name: KIMBERLY MAROTTA
Title or Position: ACCOUNTS RECEIVABLE MANAGER
Credential:
Phone: 818-782-2211