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General NPI Number Information
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NPI Number | 1447628094
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Entity Type | Organization
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Legal Business Name | THE VILLA OUTPATIENT SEVICES, LLC
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Dates
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Enumeration Date | 09/11/2015
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 4463 VAN NUYS BLVD
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-2911
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Country | US
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Telephone | 818-571-8946
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Fax |
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Provider Business Mailing Address
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Address Line | 4463 VAN NUYS BLVD
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-2911
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Country | US
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Telephone | 818-571-8946
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | GEORGIA FRABOTTA
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Credential |
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Telephone | 818-571-8946
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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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Taxonomy #2
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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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