KETAMINE TREATMENT CENTER NPI 1699522425

NPI Information

  • NPI: 1699522425
  • Provider Name: KETAMINE TREATMENT CENTER
  • Classification: Rehabilitation, Substance Use Disorder Unit - 276400000X
  • Entity Type: Organization
  • Address: 6921-6923 ALABAMA AVE
    CANOGA PARK, CA
    ZIP 91303
  • Phone: (818) 274-4609

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NPI Details

KETAMINE TREATMENT CENTER is a rehabilitation substance use disorder unit in Canoga Park, CA. The provider is a distinct part of a hospital that provides medically monitored, interdisciplinary addiction-focused treatment to patients/clients who have psychoactive substance use disorders (commonly referred to as alcohol and drug abuse or substance abuse.) KETAMINE TREATMENT CENTER NPI is 1699522425. The provider is registered as an organization entity type.

The provider's business location address is:

6921-6923 ALABAMA AVE
CANOGA PARK, CA
ZIP 91303
Phone: (818) 274-4609

The provider's authorized official is Jason Mirshojae .
The authorized official title is Employee and has the following contact phone number (818) 606-2319.

The enumeration date for this NPI number is 4/30/2024 and was last updated on 5/14/2024.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1276400000XRehabilitation, Substance Use Disorder UnitYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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