Organization · NPI-2

101 Dance Center LLC

Clinic/Center, Adult Mental Health · Los Angeles, CA

NPI number1114580677

StatusActive

Last updated in NPPESJul 16, 2024

Details

NPI: 1114580677
Entity type: Organization (NPI-2)
Legal business name: 101 Dance Center LLC
Organization subpart: No
Enumeration date: Apr 19, 2019
Certification date: Jul 16, 2024
Last updated: Jul 16, 2024

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
261QM0850X	Clinic/Center, Adult Mental Health	–	–	Yes
261QR0405X	Clinic/Center, Rehabilitation, Substance Use Disorder	–	–
324500000X	Substance Abuse Rehabilitation Facility	–	–

Other names

Casa Blanca Outpatient Services (Doing Business As)

Practice location

3246 Cahuenga Blvd W
Los Angeles, CA 90068-1302

Phone 818-731-2738

Mailing address

11319 Overlook Trl
Kagel Canyon, CA 91342-6200

Phone 818-731-2738

Authorized official

Joshua Alomia
Coo
3108696211

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