Provider Demographics
NPI:1114580677
Name:101 DANCE CENTER LLC
Entity Type:Organization
Organization Name:101 DANCE CENTER LLC
Other - Org Name:CASA BLANCA OUTPATIENT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALOMIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-869-6211
Mailing Address - Street 1:11319 OVERLOOK TRL
Mailing Address - Street 2:
Mailing Address - City:KAGEL CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:91342-6200
Mailing Address - Country:US
Mailing Address - Phone:818-731-2738
Mailing Address - Fax:
Practice Address - Street 1:3246 CAHUENGA BLVD W
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90068-1302
Practice Address - Country:US
Practice Address - Phone:818-731-2738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-19
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility