Provider Demographics
NPI:1093229593
Name:BLVD CENTERS, INC.
Entity Type:Organization
Organization Name:BLVD CENTERS, INC.
Other - Org Name:BLVD CENTERS
Other - Org Type:Other Name
Authorized Official - Title/Position:ACCOUNT COMPLIANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEFFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-277-5363
Mailing Address - Street 1:PO BOX 512030
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051-0030
Mailing Address - Country:US
Mailing Address - Phone:561-515-3227
Mailing Address - Fax:561-515-3235
Practice Address - Street 1:1776 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-4404
Practice Address - Country:US
Practice Address - Phone:561-515-3227
Practice Address - Fax:561-515-3235
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLVD CENTERS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-21
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty