Organization
MOTION PICTURE BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS C RUSSI (OWNER)
(951) 427-4897
Entity
Organization
Contact information
Practice address
5210 VISTA MIGUEL DR, LA CANADA FLINTRIDGE, CA 91011-1811
(626) 487-3417
(626) 844-6636
Mailing address
5210 VISTA MIGUEL DR, LA CANADA FLINTRIDGE, CA 91011-1811
(626) 487-3417
(626) 844-6636
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
03/31/2016
Last updated
03/31/2016
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