11821 FOOTHILL BLVD is an addiction (substance use disorder) counselor in Los Angeles, CA. 11821 FOOTHILL BLVD NPI is 1164767356. The provider is registered as an organization entity type and is a multi-specialty group.
The provider's business location address is:
5436 S. BROADWAY
LOS ANGELES, CA
ZIP 90037
Phone: (818) 694-7206
The provider's authorized official is Derrick Bradley Fortune .
The authorized official title is Counselor and has the following contact phone number (818) 694-7206.
The enumeration date for this NPI number is 11/29/2012 and was last updated on 11/29/2012.