Organization
THIRD STREET TREATMENT PARTNERS LLC
Active
Other names
Walking Miracles Los Angeles
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER BATHUM PROGRAM ADMIN ADP (CHIEF EXECUTIVE OFFICER)
(818) 635-9380
Entity
Organization
Contact information
Practice address
4067 W 3RD ST, LOS ANGELES, CA 90020-3120
(818) 635-9380
(818) 337-0365
Mailing address
4067 W 3RD ST, LOS ANGELES, CA 90020-3120
(818) 635-9380
(818) 337-0365
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
190695
CA
324500000X
Substance Abuse Rehabilitation Facility
Primary
190695
CA
Other
Enumeration date
08/11/2011
Last updated
08/11/2011
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