11821 Foothill Blvd

LBN: 11821 Foothill Blvd
11821 Foothill Blvd is an health care organization with primary practice located at 5436 S. Broadway , Los Angeles CA 90037. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as the primary health care specialty. 11821 Foothill Blvd can be contacted via phone (818) 694-7206, or through Fortune, Derrick Bradley via phone (818) 694-7206.

Contact Information

Primary practice address
5436 S. Broadway Los Angeles CA 90037
Phone: (818) 694-7206
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Fortune, Derrick Bradley BSHS
Phone: (818) 694-7206

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1164767356
LBN Legal business name 11821 Foothill Blvd
DBA Doing business as
Authorized official Fortune, Derrick Bradley BSHS
Entity Organization
Organization subpart 1 No
Enumeration date Nov 29th, 2012
Last updated Nov 29th, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Popular Providers