Organization
DUAL DIAGNOSIS ASSESSMENT AND TREATMENT CENTER, INC.
Active
Organization
DUAL DIAGNOSIS ASSESSMENT AND TREATMENT CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDNA MILLER (DIRECTOR)
(310) 590-4537
Entity
Organization
Contact information
Practice address
5354 W 64TH ST, INGLEWOOD, CA 90302-1042
(310) 590-4537
(310) 590-4538
Mailing address
19300 RINALDI ST, STE. 8270, NORTHRIDGE, CA 91326-1651
(310) 590-4537
(310) 590-4538
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CMM71096F
MEDI-CAL
CA
Enumeration date
05/25/2010
Last updated
05/25/2010
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