Organization
MHA - TAY - CHILD AND FAMILY GUIDANCE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFF ADLER PH.D. (DIRECTOR OF I.T.)
(818) 739-5125
Entity
Organization
Contact information
Practice address
310 E PALMDALE BLVD, PALMDALE, CA 93550-7145
(661) 265-8627
Mailing address
9650 ZELZAH AVE, NORTHRIDGE, CA 91325-2003
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00200
—
CA
Enumeration date
04/07/2008
Last updated
08/20/2012
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