Organization
CONNECTED OUTPATIENT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEVAN JIM CHIMAYAN (VICE PRESIDENT)
(818) 414-0525
Entity
Organization
Contact information
Practice address
14242 VENTURA BLVD STE 211, SHERMAN OAKS, CA 91423-2757
(747) 217-4033
(747) 217-4380
Mailing address
14242 VENTURA BLVD STE 211, SHERMAN OAKS, CA 91423-2757
(747) 217-4033
(747) 217-4380
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
11/10/2022
Last updated
05/24/2024
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