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21000 Plummer St Chatsworth CA 91311-4903 | |
| (818) 882-6400 | |
| (818) 882-6404 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 21000 Plummer St, Chatsworth, California |
| Authorized Official Name and Position | Zeenat K. Burse (CONTRACTS AND COMPLIANCE DIRECTOR) |
| Authorized Official Contact | 8188826400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
21000 Plummer St Chatsworth CA 91311-4903 Ph: (818) 882-6400 | 21000 Plummer St Chatsworth CA 91311-4903 Ph: (818) 882-6400 |
| NPI Number | 1245613678 |
|---|---|
| Provider Enumeration Date | 07/02/2015 |
| Last Update Date | 12/05/2024 |
| Certification Date | 12/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245613678 | NPI | - | NPPES |
| 02172 | Other | CA | LA COUNTY DEPARTMENT OF MENTAL HEALTH |
| 19B7 | Medicaid | CA | |
| 19RI | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | (* (Not Available)) | Secondary |
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