05D2165866 CLIA NUMBER - GPSTREATMENTCOM, LLC

Laboratory Demographics

CLIA Number: 05D2165866

Facility Name: GPSTREATMENTCOM, LLC

Facility Address:
10200 SEPULVEDA BLVD, STE 370
MISSION HILLS, CA
ZIP 91345
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Facility Phone Number: 818 221-3076

Facility Type: Other - SUD OUTPATIENT

Certificate Type: Waiver

NPI Number: 1013561919

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	05D2165866
LAB Type	Other - SUD OUTPATIENT
Facility Name	GPSTREATMENTCOM, LLC
Street	10200 SEPULVEDA BLVD, STE 370
City	MISSION HILLS
State	CA
ZIP	91345
Phone	818 221-3076
CertificateType	4
CertificateEffectiveDate	5/7/2023
CertificateExpirationDate	5/6/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024