Independence Community Treatment Clinic
LBN: Independence Community Treatment Clinic
Independence Community Treatment Clinic is an health care organization with primary practice located at 38801 Clock Tower Plaza Dr E Room Community Building,104,105,106,107, Palmdale CA 93550-3346. The organization recently has only one registered license in Ambulatory Health Care Facilities / Community Health, which is considered as the primary health care specialty.
Independence Community Treatment Clinic can be contacted via phone (818) 776-1755, or through Brnzburg, Alex via phone (818) 776-1755.
Contact Information
Primary practice address
38801 Clock Tower Plaza Dr E Room Community Building,104,105,106,107
Palmdale CA 93550-3346
Phone: (818) 776-1755
Fax: (818) 776-1657
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Community Health | 261QC1500X | 960001358 | California |
Profile Details
| NPI number | 1710122866 |
|---|---|
| LBN Legal business name | Independence Community Treatment Clinic |
| DBA Doing business as | |
| Authorized official | Brnzburg, Alex |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 3rd, 2008 |
| Last updated | Dec 11th, 2009 - about 15 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710122866 | NPPES |
| California | MEDICAID | CMM70956F | |
| California | MEDICAID | 196856000 |
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