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General NPI Number Information
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NPI Number | 1821114828
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Entity Type | Organization
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Legal Business Name | TARZANA TREATMENT CENTERS, INC.
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 18700 OXNARD ST
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City | TARZANA
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State | CA
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Zip | 91356-1413
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Country | US
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Telephone | 818-996-1051
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Fax |
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Provider Business Mailing Address
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Address Line | 18646 OXNARD ST
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City | TARZANA
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State | CA
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Zip | 91356-1411
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Country | US
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Telephone | 818-996-3911
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/ CHIEF EXECUTIVE OFFICER
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Name | ALBERT SENELLA
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Credential |
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Telephone | 818-654-3815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 180085HN
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License Number State | CA
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