Organization
PHASE TWO ATC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDAN FREEMAN (CEO)
(855) 740-1181
Entity
Organization
Contact information
Practice address
15720 VENTURA BLVD STE PH, ENCINO, CA 91436-2914
(855) 740-1181
Mailing address
15720 VENTURA BLVD STE PH, ENCINO, CA 91436-2914
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
05/06/2020
Last updated
10/26/2020
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