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General NPI Number Information
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NPI Number | 1265255509
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Entity Type | Organization
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Legal Business Name | EMA CMHC
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 803 CAMARILLO SPRINGS RD # F
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City | CAMARILLO
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State | CA
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Zip | 93012-9459
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Country | US
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Telephone | 805-322-8685
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Fax | 805-504-1801
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Provider Business Mailing Address
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Address Line | 803 CAMARILLO SPRINGS RD # F
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City | CAMARILLO
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State | CA
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Zip | 93012-9459
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Country | US
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Telephone | 805-322-8685
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Fax | 805-504-1801
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Authorized Official
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Title or Position | CEO
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Name | MERY BALAYAN
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Credential |
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Telephone | 818-653-5454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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