MEDICARE: SADAG TREATMENT SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1255111035
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SADAG TREATMENT SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	8338 SALE AVE
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91304-3339
Country	:	US
Telephone Number	:	888-413-4466
Fax Number	:

Provider Business Practice Location Address
First Line	:	8338 SALE AVE
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91304-3339
Country	:	US
Telephone Number	:	888-413-4466
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	GEORGE AGAMALIAN
Credential	:
Telephone Number	:	818-726-9922

Provider Enumeration Date	:	09/29/2023
Last Update Date	:	09/29/2023

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