11821 Foothill Blvd
Counselor - Addiction (Substance Use Disorder)
About 11821 Foothill Blvd
11821 Foothill Blvd is a healthcare organization providing Counselor - Addiction (Substance Use Disorder) services, with specialized expertise in Addiction (Substance Use Disorder), registered under National Provider Identifier (NPI) number 1164767356.
The authorized official for 11821 Foothill Blvd is DERRICK FORTUNE. The organization is headquartered at 5436 S. BROADWAY, Los Angeles, California 90037. The main office can be reached at (818) 694-7206. 11821 Foothill Blvd has been NPI-registered since 2012.
Locations & Contact
Primary Location
- Address
- 5436 S. BROADWAY
- City
- Los Angeles
- State
- California
- ZIP
- 90037
- Phone
- (818) 694-7206
Authorized Official
- Name
- DERRICK FORTUNE
Mailing Address
- Address
- 11821 FOOTHILL BLVD # K35
- City
- LAKE VIEW TERRACE
- State
- CA
- ZIP
- 913427200
NPI Registration
- Enumeration Date
- Last Updated
- Certification Date
Services & Taxonomy
Specialty & Classification
- Primary Specialty
- Counselor - Addiction (Substance Use Disorder)
- Classification
- Counselor
- Specialization
- Addiction (Substance Use Disorder)
- Taxonomy Code
- 101YA0400X
Medicare Enrollment
- Medicare Enrolled
- No
- Can Order/Refer
- No
- Telehealth
- No
- Excluded
- No
Frequently Asked Questions
What is 11821 Foothill Blvd's NPI number?
What does 11821 Foothill Blvd specialize in?
Where is 11821 Foothill Blvd located?
Does 11821 Foothill Blvd accept Medicare?
Does 11821 Foothill Blvd offer telehealth or virtual visits?
What is a Type 2 NPI (Organization)?
A Type 2 NPI is assigned to healthcare organizations such as hospitals, group practices, clinics, and other medical entities. Unlike Type 1 NPIs issued to individual providers, a Type 2 NPI identifies the organization itself and is used for billing, claims processing, and identification in healthcare transactions. 11821 Foothill Blvd holds NPI 1164767356, which serves as its unique identifier across all Medicare and HIPAA-covered transactions.