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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