Growth Extended

NPI 1073854147 - Substance Abuse Rehabilitation Facility - 324500000X

NPI Details
NPI 1073854147
Enumeration Date 03/14/2013
Last Updated 10/14/2015
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name SIEU SIEU
Position DIRECTOR OF OPERATION
Phone (888) 549-8884
Fax (888) 751-6166
Practice Location
439 S SERRANO AVE
LOS ANGELES CA, 90020-3604, US
Phone (888) 549-8884
Fax (888) 751-6166
Business Location
PO BOX 910903
LOS ANGELES CA, 90091-0903, US
Phone (888) 549-8884
Fax (888) 751-6166
Toxanomy
Taxonomy Code 324500000X
License State California
License Number 198206009
Remove 1073854147 NPI Number
 

According to our database, Growth Extended NPI is 1073854147, taxonomy code is 324500000X and license number is 198206009, license state is located at California. Growth Extended physically located at 439 S Serrano Ave, Los Angeles CA, 90020-3604. NPI Number 1033115704 has the healthcare provider type.

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1073854147 NPI number is provided on an as is basis without warranty of any kind. 1073854147 is maintained by the National Plan & Provider Enumeration System. The contents of Growth Extended are for informational purposes only.