Provider Demographics
NPI:1528567138
Name:HEALTHY PARADIGMS TREATMENT CENTER
Entity Type:Organization
Organization Name:HEALTHY PARADIGMS TREATMENT CENTER
Other - Org Name:HEALTHY PARADIGMS TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DAGMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:LIEPA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-904-9008
Mailing Address - Street 1:14407 HAMLIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-6200
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14407 HAMLIN ST STE C
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-6200
Practice Address - Country:US
Practice Address - Phone:818-660-0882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHY PARADIGMS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-08
Last Update Date:2022-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder