# AMEN CLINICS INC, LA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** AMEN CLINICS, INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1871119982
- **Legal business name:** AMEN CLINICS, INC
- **Authorized official:** CHRISTINA T MCCORMICK MS (DATA SYSTEMS SPECIALIST)
- **Authorized official phone:** (703) 880-4000

## Contact information

- **Practice address:** 5363 BALBOA BLVD STE 100, ENCINO, CA 91316-2802
- **Practice address phone:** (818) 479-4400
- **Practice address fax:** (818) 305-3779
- **Mailing address:** 5363 BALBOA BLVD STE 100, ENCINO, CA 91316-2802
- **Mailing address phone:** (818) 479-4400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084D0003X | Diagnostic Neuroimaging (Psychiatry & Neurology) Physician | — | NULL | Yes |
| 2084D0003X | Diagnostic Neuroimaging (Psychiatry & Neurology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/24/2020
- **Last updated:** 06/24/2020