Organization
CENTURY REGIONAL DETENTION FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY DAVID MA (PSYCHOLOGY INTERN)
(818) 255-8254
Entity
Organization
Contact information
Practice address
6610 RIVERTON AVE, NORTH HOLLYWOOD, CA 91606-2209
(818) 255-8254
Mailing address
6610 RIVERTON AVE, NORTH HOLLYWOOD, CA 91606-2209
(818) 255-8254
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
390200000X
CA
Other
Enumeration date
11/24/2008
Last updated
11/24/2008
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