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General NPI Number Information
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NPI Number | 1952598930
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Entity Type | Organization
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Legal Business Name | ABSOLUTE CONTROL TRANSITIONAL COUNSELING CENTER, INC.
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Dates
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Enumeration Date | 10/03/2007
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Last Update Date | 05/20/2013
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Provider Practice Location Address
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Address Line | 3111 WINONA AVE. # 201
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City | BURBANK
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State | CA
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Zip | 91504
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Country | US
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Telephone | 626-792-8797
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Fax | 626-792-8798
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Provider Business Mailing Address
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Address Line | 3111 WINONA AVE UNIT 201
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City | BURBANK
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State | CA
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Zip | 91504-2538
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Country | US
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Telephone | 626-792-8797
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Fax | 626-792-8798
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | OGANES NARDOS
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Credential | CAADAC
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Telephone | 626-792-8797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 190462AP
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License Number State | CA
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