Provider Demographics
NPI:1124568233
Name:SLEA
Entity Type:Organization
Organization Name:SLEA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIORAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ARMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JANJIKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DL
Authorized Official - Phone:818-307-2132
Mailing Address - Street 1:10285 TUJUNGA CANYON BLVD
Mailing Address - Street 2:109
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-2253
Mailing Address - Country:US
Mailing Address - Phone:818-307-2132
Mailing Address - Fax:
Practice Address - Street 1:10285 TUJUNGA CANYON BLVD
Practice Address - Street 2:109
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-2253
Practice Address - Country:US
Practice Address - Phone:818-307-2132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health