Provider Demographics
NPI:1245408269
Name:TOTAL FAMILY SUPPORT CLINIC
Entity Type:Organization
Organization Name:TOTAL FAMILY SUPPORT CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:SKARLATO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:818-833-9789
Mailing Address - Street 1:13741 FOOTHILL BLVD
Mailing Address - Street 2:270
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-3133
Mailing Address - Country:US
Mailing Address - Phone:818-833-9789
Mailing Address - Fax:818-833-9790
Practice Address - Street 1:5820 WEST BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90043-3023
Practice Address - Country:US
Practice Address - Phone:818-833-9789
Practice Address - Fax:818-833-9790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty