Provider Demographics
NPI:1730678079
Name:MT GOLDEN CORPORATION
Entity Type:Organization
Organization Name:MT GOLDEN CORPORATION
Other - Org Name:ADJUSTMENTS FAMILY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MCKAY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-228-2826
Mailing Address - Street 1:7133 DARBY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4428
Mailing Address - Country:US
Mailing Address - Phone:805-228-2826
Mailing Address - Fax:818-401-9387
Practice Address - Street 1:3010 E LOS ANGELES AVE
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-3939
Practice Address - Country:US
Practice Address - Phone:805-228-2826
Practice Address - Fax:818-401-9387
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MT GOLDEN CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-02
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder