Pacific Lodge Youth Services
LBN: Optimist Boys Home & Ranch, Inc.
Pacific Lodge Youth Services is an health care organization with primary practice located at 4900 Serrania Ave , Woodland Hills CA 91364-3301. The organization recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Agencies / Community/Behavioral Health. Agencies / Community/Behavioral Health is the primary health care specialty.
Optimist Boys Home & Ranch, Inc. can be contacted via phone (818) 657-3123, or through Sosna, Todd David via phone (323) 443-3001.
Contact Information
Primary practice address
4900 Serrania Ave
Woodland Hills CA 91364-3301
Phone: (818) 657-3123
Fax: (818) 347-1326
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X | ||
| Agencies / Community/Behavioral Health | 251S00000X |
Profile Details
| NPI number | 1174066435 |
|---|---|
| LBN Legal business name | Optimist Boys Home & Ranch, Inc. |
| DBA Doing business as | Pacific Lodge Youth Services |
| Authorized official | Sosna, Todd David PH.D. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 18th, 2016 |
| Last updated | May 22nd, 2023 - about last year |
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 | 1174066435 | NPPES |
| California | Other | 00781 | MEDI-CAL PROVIDER |
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