| Youth Contact Will Rog Hs | |
|
14711 Gilmore St Van Nuys CA 91411-1595 | |
| (818) 908-4990 | |
| Not Available |
| Full Name | Youth Contact Will Rog Hs |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 14711 Gilmore St, Van Nuys, California |
| Authorized Official Name and Position | Timothy Ryder (PRESIDENT) |
| Authorized Official Contact | 8189014830 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Contact Will Rog Hs 16360 Roscoe Blvd Ste 200 Van Nuys CA 91406-1213 Ph: (818) 901-4830 | Youth Contact Will Rog Hs 14711 Gilmore St Van Nuys CA 91411-1595 Ph: (818) 908-4990 |
| NPI Number | 1245865237 |
|---|---|
| Provider Enumeration Date | 03/10/2020 |
| Last Update Date | 03/16/2020 |
| Certification Date | 03/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245865237 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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