Organization
ALTA CENTERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA VAN KOVN (CEO)
(818) 616-7443
Entity
Organization
Contact information
Practice address
5435 BALBOA BLVD, SUITE 103, ENCINO, CA 91316-1508
(818) 616-7443
(818) 301-2046
Mailing address
5435 BALBOA BLVD, SUITE 103, ENCINO, CA 91316-1508
(818) 616-7443
(818) 301-2046
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190852
CA
Other
Enumeration date
08/14/2015
Last updated
06/11/2019
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