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General NPI Number Information
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NPI Number | 1841568573
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Entity Type | Organization
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Legal Business Name | NEURO BALANCE AND BEHAVIORAL CENTER INC
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Dates
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Enumeration Date | 12/08/2011
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Last Update Date | 06/14/2012
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Provider Practice Location Address
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Address Line | 427 W COLORADO ST STE 104
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City | GLENDALE
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State | CA
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Zip | 91204-3045
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Country | US
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Telephone | 818-245-8133
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Fax | 818-245-8134
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Provider Business Mailing Address
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Address Line | 427 W COLORADO ST STE 104
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City | GLENDALE
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State | CA
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Zip | 91204-3045
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Country | US
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Telephone | 818-245-8133
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Fax | 818-245-8134
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Authorized Official
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Title or Position | DIRECTOR
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Name | AREVIK VICTORIA ARAMIAN
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Credential | ETC
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Telephone | 818-245-8133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | PZUC1119500
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License Number State | CA
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