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Organization
SEPULVEDA REHABILITATION CENTER
Active
Organization
SEPULVEDA REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK SAMUEL (EXECUTIVE DIRECTOR)
(818) 901-8091
Entity
Organization
Contact information
Practice address
7633 VAN NUYS BLVD, VAN NUYS, CA 91405-1359
(818) 901-8091
Mailing address
7633 VAN NUYS BLVD, VAN NUYS, CA 91405-1359
(818) 901-8091
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
7196
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7196
PROVIDER NUMBER
CA
Enumeration date
04/12/2007
Last updated
08/22/2020
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