Provider Demographics
NPI:1164202438
Name:CRT PROGRAMS INC.
Entity Type:Organization
Organization Name:CRT PROGRAMS INC.
Other - Org Name:CRT PROGRAMS SYLMAR
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHROUZ
Authorized Official - Middle Name:
Authorized Official - Last Name:GHODSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-709-7355
Mailing Address - Street 1:1001 GAYLEY AVE UNIT 24886
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-3575
Mailing Address - Country:US
Mailing Address - Phone:310-552-2273
Mailing Address - Fax:
Practice Address - Street 1:14124 BUCHER AVE
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-1424
Practice Address - Country:US
Practice Address - Phone:888-818-7762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRT PROGRAMS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-03
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility