Organization
CALIFORNIA STATE UNIVERSITY NORTHRIDGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TIFFANY BROOKS LCSW (FIELD CONSULTANT LIAISON SW DEPT)
(310) 351-1809
Entity
Organization
Contact information
Practice address
5300 W AVENUE I, LANCASTER, CA 93536-8312
(661) 940-4122
Mailing address
18111 NORDHOFF ST, NORTHRIDGE, CA 91330-8226
(818) 677-1200
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/02/2015
Last updated
09/02/2015
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