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General NPI Number Information
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NPI Number | 1114580677
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Entity Type | Organization
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Legal Business Name | 101 DANCE CENTER LLC
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Dates
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Enumeration Date | 04/19/2019
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | 3246 CAHUENGA BLVD W
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City | LOS ANGELES
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State | CA
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Zip | 90068-1302
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Country | US
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Telephone | 818-731-2738
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Fax |
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Provider Business Mailing Address
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Address Line | 11319 OVERLOOK TRL
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City | KAGEL CANYON
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State | CA
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Zip | 91342-6200
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Country | US
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Telephone | 818-731-2738
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Fax |
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Authorized Official
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Title or Position | COO
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Name | JOSHUA ALOMIA
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Credential |
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Telephone | 310-869-6211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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