Provider Demographics
NPI:1750821773
Name:I AM TREATMENT SANCTUARIES, INC.
Entity Type:Organization
Organization Name:I AM TREATMENT SANCTUARIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:AUBREY
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-510-2706
Mailing Address - Street 1:651 CASTANO AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-2703
Mailing Address - Country:US
Mailing Address - Phone:626-510-2706
Mailing Address - Fax:
Practice Address - Street 1:651 CASTANO AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-2703
Practice Address - Country:US
Practice Address - Phone:626-510-2706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility