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General NPI Number Information
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NPI Number | 1235958059
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Entity Type | Organization
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Legal Business Name | INNERCHANGE OPI, LLC
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 5052 CAMPO RD
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-1923
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Country | US
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Telephone | 818-610-3956
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Fax |
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Provider Business Mailing Address
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Address Line | 5500 MING AVE STE 410
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City | BAKERSFIELD
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State | CA
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Zip | 93309-4631
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | SHARNELL SPENCER
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Credential |
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Telephone | 661-239-6923
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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