Provider First Line Business Practice Location Address:
18646 OXNARD ST.
Provider Second Line Business Practice Location Address:
TARZANA TREATMENT CENTER
Provider Business Practice Location Address City Name:
TARZANA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91356
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-996-1051
Provider Business Practice Location Address Fax Number:
818-345-3778
Provider Enumeration Date:
10/18/2012