Organization
LICASA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILIT MURADYAN (CEO)
(818) 210-6612
Entity
Organization
Contact information
Practice address
7041 RESEDA BLVD, RESEDA, CA 91335-4209
(818) 210-6612
Mailing address
7041 RESEDA BLVD, RESEDA, CA 91335-4209
(818) 210-6612
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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