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General NPI Number Information
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NPI Number | 1831314251
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Entity Type | Organization
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Legal Business Name | TOPANGA ROSCOE CORPORATION
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 22115 ROSCOE BLVD
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City | CANOGA PARK
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State | CA
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Zip | 91304-3839
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Country | US
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Telephone | 818-884-8100
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Fax | 818-884-7808
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Provider Business Mailing Address
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Address Line | 22115 ROSCOE BLVD
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City | CANOGA PARK
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State | CA
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Zip | 91304-3839
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Country | US
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Telephone | 818-884-8100
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Fax | 818-884-7808
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Authorized Official
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Title or Position | PRESIDENT
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Name | CARY BUCHMAN
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Credential |
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Telephone | 818-884-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 191202140
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License Number State | CA
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