Provider Demographics
NPI:1821252354
Name:EQUILIBRIUM HEALTH SERIVCES INC
Entity Type:Organization
Organization Name:EQUILIBRIUM HEALTH SERIVCES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:CHIEDU
Authorized Official - Last Name:BIOSAH
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:818-997-1930
Mailing Address - Street 1:14535 HAMLIN ST
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-1608
Mailing Address - Country:US
Mailing Address - Phone:818-997-1930
Mailing Address - Fax:
Practice Address - Street 1:14535 HAMLIN ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-1608
Practice Address - Country:US
Practice Address - Phone:818-997-1930
Practice Address - Fax:818-997-1905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-14
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service