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General NPI Number Information
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NPI Number | 1942916127
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Entity Type | Organization
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Legal Business Name | THE TEEN PROJECT, INC.
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Dates
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Enumeration Date | 01/30/2023
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 14520 SYLVAN ST FL 3
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City | VAN NUYS
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State | CA
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Zip | 91411-2324
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Country | US
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Telephone | 818-582-8322
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Fax |
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Provider Business Mailing Address
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Address Line | 14520 SYLVAN ST FL 3
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City | VAN NUYS
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State | CA
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Zip | 91411-2324
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Country | US
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Telephone | 818-582-8832
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Fax | 818-582-8836
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LAURI LYNNE BURNS
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Credential |
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Telephone | 818-582-8832
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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