Provider Demographics
NPI:1568994291
Name:ACTION FAMILY COUNSELING - SCV INC
Entity Type:Organization
Organization Name:ACTION FAMILY COUNSELING - SCV INC
Other - Org Name:ACTION FAMILY COUNSELING - SANTA CLARITA OUTPATIENT SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:QUASHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-705-5914
Mailing Address - Street 1:26893 BOUQUET CANYON RD STE C-134
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-3500
Mailing Address - Country:US
Mailing Address - Phone:800-367-8336
Mailing Address - Fax:661-297-9701
Practice Address - Street 1:691 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:PIRU
Practice Address - State:CA
Practice Address - Zip Code:93040
Practice Address - Country:US
Practice Address - Phone:800-367-8336
Practice Address - Fax:661-297-9701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-31
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
323P00000X
CA560026DP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility