Basic Information
Provider Information
NPI: 1841581022
EntityType: 2
ReplacementNPI:  
OrganizationName: TARZANA TREATMENT CENTERS, INC.
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Mailing Information
Address1: 18646 OXNARD ST
Address2:  
City: TARZANA
State: CA
PostalCode: 913561411
CountryCode: US
TelephoneNumber: 8189961051
FaxNumber: 8189963051
Practice Location
Address1: 44459 & 44461 10TH STREET
Address2:  
City: LANCASTER
State: CA
PostalCode: 93534
CountryCode: US
TelephoneNumber: 8189961051
FaxNumber: 8189963051
Other Information
ProviderEnumerationDate: 04/22/2011
LastUpdateDate: 05/04/2017
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: SENELLA
AuthorizedOfficialFirstName: ALBERT
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AuthorizedOfficialTitleorPosition: PRESIDENT/CHIEF OPERATING OFFICER
AuthorizedOfficialTelephone: 8189961051
IsSoleProprietor:  
IsOrganizationSubpart: N
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251S00000X  Y AgenciesCommunity/Behavioral Health 

No ID Information.


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