Organization
KETAMINE TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON MIRSHOJAE (EMPLOYEE)
(818) 606-2319
Entity
Organization
Contact information
Practice address
6921-6923 ALABAMA AVE, CANOGA PARK, CA 91303
(818) 274-4609
Mailing address
5985 TOPANGA CANYON BLVD, WOODLAND HILLS, CA 91367-3623
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
—
—
Other
Enumeration date
04/30/2024
Last updated
05/14/2024
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