INDEPENDENCE COMMUNITY TREATMENT CLINIC NPI 1699948810

NPI Information

NPI: 1699948810
Provider Name: INDEPENDENCE COMMUNITY TREATMENT CLINIC
Classification: Clinic/Center - 261QC1500X
Entity Type: Organization

Specialization: Community Health

Address:
44701 32ND ST W
LANCASTER HIGH SCHOOL
LANCASTER, CA
ZIP 93536
Phone: (818) 776-1755
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INDEPENDENCE COMMUNITY TREATMENT CLINIC is a community health clinic center in Lancaster, CA. INDEPENDENCE COMMUNITY TREATMENT CLINIC NPI is 1699948810. The provider is registered as an organization entity type.

The provider's business location address is:

44701 32ND ST W
LANCASTER HIGH SCHOOL
LANCASTER, CA
ZIP 93536-023
Phone: (818) 776-1755
Fax: (818) 776-1657

The provider's authorized official is Alex Branzburg .
The authorized official title is Program Director and has the following contact phone number (818) 776-1755.

The enumeration date for this NPI number is 4/9/2008 and was last updated on 4/9/2008.

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
1	261QC1500X	Clinic/Center	Community Health		CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CMM70956F	MEDICAID	CALIFORNIA

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: 5/5/2024

NPI Synchronization or Removal

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