Provider Demographics
NPI:1225153877
Name:TARZANA TREATMENT CENTER
Entity Type:Organization
Organization Name:TARZANA TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR1
Authorized Official - Prefix:MR
Authorized Official - First Name:NICK
Authorized Official - Middle Name:DAN
Authorized Official - Last Name:SPALLIERO
Authorized Official - Suffix:SR
Authorized Official - Credentials:CDS
Authorized Official - Phone:661-726-2630
Mailing Address - Street 1:907 EAST LANCASTER BLVD.
Mailing Address - Street 2:17725 EAST COOLWATER
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534
Mailing Address - Country:US
Mailing Address - Phone:661-726-2630
Mailing Address - Fax:
Practice Address - Street 1:907 EAST LANCASTER BLVD.
Practice Address - Street 2:17725 EAST COOLWATER
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534
Practice Address - Country:US
Practice Address - Phone:661-726-2630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility