Provider First Line Business Practice Location Address:
14445 OLIVE VIEW DRIVE
Provider Second Line Business Practice Location Address:
SOCIAL WORK DEPT. 1A139
Provider Business Practice Location Address City Name:
SYLMAR
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91342
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
747-210-4236
Provider Business Practice Location Address Fax Number:
747-210-4239
Provider Enumeration Date:
10/02/2012