Pacific Lodge Campus

LBN: Optimist Boys' Home & Ranch, Inc.
Pacific Lodge Campus is an health care organization with primary practice located at 4900 Serrania Ave , Woodland Hills CA 91364-3301. The organization recently has only one registered license in Residential Treatment Facilities / Psychiatric Residential Treatment Facility, which is considered as the primary health care specialty. Optimist Boys' Home & Ranch, Inc. can be contacted via phone (818) 657-3123, or through Sosna, Todd via phone (323) 443-3101.

Contact Information

Primary practice address
4900 Serrania Ave Woodland Hills CA 91364-3301
Phone: (818) 657-3123
Fax: (818) 347-1326
Website:
Map and Directions
Authorized official contact:
Name: Sosna, Todd PH.D.
Phone: (323) 443-3101

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Psychiatric Residential Treatment Facility 323P00000X 198209477 California

Profile Details

NPI number 1598208696
LBN Legal business name Optimist Boys' Home & Ranch, Inc.
DBA Doing business as Pacific Lodge Campus
Authorized official Sosna, Todd PH.D.
Entity Organization
Organization subpart 1 No
Enumeration date Nov 22nd, 2016
Last updated May 18th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598208696 NPPES
California Other 00781 MEDI-CAL PROVIDER

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