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General NPI Number Information
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NPI Number | 1346040268
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Entity Type | Organization
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Legal Business Name | VIP COMMUNITY MENTAL HEALTH CENTER, INC
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 3016 N MAIN ST
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City | LOS ANGELES
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State | CA
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Zip | 90031-2620
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Country | US
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Telephone | 323-221-4134
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Fax |
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Provider Business Mailing Address
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Address Line | 1721 GRIFFIN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90031-3312
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Country | US
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Telephone | 323-221-4134
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DUSTIN SCHIADA
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Credential |
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Telephone | 323-221-4134
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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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