Organization
DUAL DIAGNOSIS ASSESSMENT AND TREATMENT CENTER
Active
Organization
DUAL DIAGNOSIS ASSESSMENT AND TREATMENT CENTER
Active
Other names
Health Care Dual Diagnosis
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EDNA ELIZABETH MILLER (PRESIDENT)
(310) 628-9512
Entity
Organization
Contact information
Practice address
3545 WILSHIRE BLVD, LOS ANGELES, CA 90010-2388
(310) 628-9512
(818) 804-4043
Mailing address
19300 RINALDI ST, SUITE 8270, NORTHRIDGE, CA 91326-1651
(310) 628-9512
(818) 392-5025
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
96000148
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CMM71096F
MEDI-CAL
CA
Enumeration date
05/31/2006
Last updated
03/03/2008
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