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4789 Vineland Ave North Hollywood CA 91602-3518 | |
| (213) 347-4022 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4789 Vineland Ave, North Hollywood, California |
| Authorized Official Name and Position | Terence C Frost (PRESIDENT) |
| Authorized Official Contact | 2133474022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5748 Willowcrest Ave North Hollywood CA 91601-2122 Ph: (213) 347-4022 | 4789 Vineland Ave North Hollywood CA 91602-3518 Ph: (213) 347-4022 |
| NPI Number | 1932940889 |
|---|---|
| Provider Enumeration Date | 06/04/2024 |
| Last Update Date | 06/25/2024 |
| Certification Date | 06/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932940889 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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