Organization
VOGUE RECOVERY CENTER OUTPATIENT
Active
Organization
VOGUE RECOVERY CENTER OUTPATIENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CECILIA VALENZUELA (BILLING SPECIALIST)
(818) 280-8063
Entity
Organization
Contact information
Practice address
4122 N 17TH ST BLDG C, PHOENIX, AZ 85016-5922
(818) 304-8071
Mailing address
16501 SHERMAN WAY STE 100, VAN NUYS, CA 91406-3757
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTC9282
DEPARTMENT OF HEALTH SERVICES
AZ
Enumeration date
12/26/2018
Last updated
03/31/2020
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