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NPI Code Detail

MEDICARE: DEVELOPMENT SPECIALTY PROJECTS, INC.

MEDICARE: DEVELOPMENT SPECIALTY PROJECTS, 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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center190419DPCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17072OTHERCADMC PROVIDER NUMBER

General Provider Information

NPI Number : 1548471303
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEVELOPMENT SPECIALTY PROJECTS, INC.
Provider Business Mailing Address
First Line : 19300 RINALDI ST
Second Line : SUITE 8270
City : NORTHRIDGE
State : CA
Zip : 91326-1651
Country : US
Telephone Number : 909-821-8023
Fax Number : 818-804-4047
Provider Business Practice Location Address
First Line : 4800 FRESHMAN DR
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-3519
Country : US
Telephone Number : 909-821-8023
Fax Number : 818-804-4047
Authorized Official
Title or Position : PRESIDENT
Name : MR. DAVID MCGUIRE
Credential :
Telephone Number : 909-821-8023
Provider Enumeration Date : 05/24/2007
Last Update Date : 01/17/2008

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