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NPI Code Detail

MEDICARE: TARZANA TREATMENT CENTERS, INC

MEDICARE: TARZANA TREATMENT CENTERS, INC
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
1324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1285175315
Entity Type Code : Organization
Provider Name (Legal Business Name) : TARZANA TREATMENT CENTERS, INC
Provider Business Mailing Address
First Line : 18646 OXNARD ST
Second Line :
City : TARZANA
State : CA
Zip : 91356-1411
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 44505 90TH ST W
Second Line :
City : LANCASTER
State : CA
Zip : 93536-7705
Country : US
Telephone Number : 818-996-1051
Fax Number : 818-996-3051
Authorized Official
Title or Position : PRESIDENT/CHIEF EXECUTIVE OFFICER
Name : ALBERT SENELLA
Credential :
Telephone Number : 818-654-3815
Provider Enumeration Date : 03/08/2017
Last Update Date : 12/11/2024

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