Organization
POM POM CASTLE
Active
Parent organization
POM POM CASTLE DBA CLEAN AND FREE
Other names
Clean and Free
Organization subpart
Yes
Provider details
NPI number
Legal business name
POM POM CASTLE DBA CLEAN AND FREE
Authorized official
BELINDA BAKER (EXECUTIVE DIRECTOR)
(323) 294-1576
Entity
Organization
Contact information
Practice address
14540 HAMLIN ST, SUITE D, VAN NUYS, CA 91411-1626
(818) 994-6876
(818) 997-6878
Mailing address
14540 HAMLIN ST, SUITE D, VAN NUYS, CA 91411-1626
(818) 994-6876
(818) 997-6878
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
01/19/2012
Last updated
01/19/2012
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