Organization
8025 SEPULVEDA LLC
Active
Other names
Sepulveda Residential
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK SAMUELS (ADMINISTRATOR)
(818) 782-7288
Entity
Organization
Contact information
Practice address
8025 SEPULVEDA BLVD, VAN NUYS, CA 91402
(818) 782-7288
Mailing address
8025 SEPULVEDA BLVD, VAN NUYS, CA 91402
(818) 782-7288
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/16/2008
Last updated
06/16/2008
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