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General NPI Number Information
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NPI Number | 1134842644
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Entity Type | Organization
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Legal Business Name | VIRTUE AT THE POINTE RECOVERY CENTER LLC
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Dates
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Enumeration Date | 09/20/2022
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 6902 SE LAKE RD STE 302
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City | MILWAUKIE
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State | OR
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Zip | 97267-2148
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Country | US
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Telephone | 818-928-0025
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Fax |
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Provider Business Mailing Address
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Address Line | 5850 CANOGA AVE STE 130
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-6505
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Country | US
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Telephone | 818-928-0025
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Fax |
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Authorized Official
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Title or Position | SENIOR BILLING REP
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Name | MARLA MEZA
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Credential |
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Telephone | 323-212-2096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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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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