Provider Demographics
NPI:1790906907
Name:TARZANZA TREATMENT CENTER
Entity Type:Organization
Organization Name:TARZANZA TREATMENT CENTER
Other - Org Name:TTC
Other - Org Type:Other Name
Authorized Official - Title/Position:COUNSELOR 1
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:JUNE
Authorized Official - Last Name:FUGITT
Authorized Official - Suffix:
Authorized Official - Credentials:CCDC
Authorized Official - Phone:661-726-2630
Mailing Address - Street 1:907 W LANCASTER BLVD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2305
Mailing Address - Country:US
Mailing Address - Phone:661-726-2630
Mailing Address - Fax:
Practice Address - Street 1:907 W LANCASTER BLVD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2305
Practice Address - Country:US
Practice Address - Phone:661-726-2630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health