Organization
7 ALPHA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUQMAN YUSEF WATKINS (EXECUTIVE DIRECTOR)
(818) 319-0650
Entity
Organization
Contact information
Practice address
37025 LA CONTEMPO AVE, PALMDALE, CA 93550-7351
(661) 405-9792
Mailing address
223 LAKEVIEW DR, PALMDALE, CA 93551-7933
(661) 405-9792
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Enumeration date
10/28/2025
Last updated
11/07/2025
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