BOYS REPUBLIC - SILVERLAKE NPI 1023560836

NPI Information

BOYS REPUBLIC - SILVERLAKE is a community based residential treatment facility mental illness in Los Angeles, CA. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. BOYS REPUBLIC - SILVERLAKE NPI is 1023560836. The provider is registered as an organization entity type.
The provider Other Name Is Boys Republic - Silverlake.

The provider's business location address is:

1815 REDCLIFF ST
LOS ANGELES, CA
ZIP 90026-133
Phone: (323) 661-6905
Fax: (909) 306-5427

The provider's authorized official is Eitan Kadosh .
The authorized official title is Head Of Service and has the following contact phone number (909) 703-0749.

The enumeration date for this NPI number is 10/27/2016 and was last updated on 11/11/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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