# INDEPENDENCE COMMUNITY TREATMENT CLINIC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699948810
- **Authorized official:** ALEX BRANZBURG (PROGRAM DIRECTOR)
- **Authorized official phone:** (818) 776-1755

## Contact information

- **Practice address:** 44701 32ND ST W, LANCASTER HIGH SCHOOL, LANCASTER, CA 93536-7023
- **Practice address phone:** (818) 776-1755
- **Practice address fax:** (818) 776-1657
- **Mailing address:** 19231 VICTORY BLVD, SUITE 554, RESEDA, CA 91335-6308
- **Mailing address phone:** (818) 776-1755
- **Mailing address fax:** (818) 776-1657

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | CA | Yes |

## Other

- **Enumeration date:** 04/09/2008
- **Last updated:** 04/09/2008