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Organization
LAS VIRGENES BEHAVIORAL HEALTH AND MEDICAL CLINIC, INC
Active
Organization
LAS VIRGENES BEHAVIORAL HEALTH AND MEDICAL CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRINA CHMELEVA (BILLER)
(818) 879-9018
Entity
Organization
Contact information
Practice address
30101 AGOURA CT STE 100, AGOURA HILLS, CA 91301-4301
(818) 879-9018
(818) 879-9013
Mailing address
30101 AGOURA CT STE 100, AGOURA HILLS, CA 91301-4301
(818) 879-9018
(818) 879-9013
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
—
NULL
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
—
—
Other
Enumeration date
06/18/2007
Last updated
03/27/2018
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