Provider Demographics
NPI:1346852746
Name:PSYCLARITY HEALTH INC.
Entity Type:Organization
Organization Name:PSYCLARITY HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWNOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-265-9704
Mailing Address - Street 1:22450 COLLINS ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-4430
Mailing Address - Country:US
Mailing Address - Phone:832-312-9611
Mailing Address - Fax:949-861-9245
Practice Address - Street 1:22450 COLLINS ST
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-4430
Practice Address - Country:US
Practice Address - Phone:832-312-9611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA191055APOtherDHCS