# PACIFIC LODGE YOUTH SERVICES, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PACIFIC LODGE YOUTH SERVICES
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1942506860
- **Legal business name:** PACIFIC LODGE YOUTH SERVICES
- **Authorized official:** MRS. LISA E ALEGRIA (PRESIDENT CEO)
- **Authorized official phone:** (818) 657-3104

## Contact information

- **Practice address:** 22030 SHERMAN WAY STE 215, CANOGA PARK, CA 91303-1883
- **Practice address phone:** (818) 347-1577
- **Mailing address:** 22030 SHERMAN WAY STE 215, CANOGA PARK, CA 91303-1883
- **Mailing address phone:** (818) 347-1577

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0401X | Comprehensive Outpatient Rehabilitation Facility (CORF) | — | NULL | Yes |

## Other

- **Enumeration date:** 02/10/2011
- **Last updated:** 02/10/2011