Provider Demographics
NPI:1356563753
Name:BETTER LIFE ADHC
Entity type:Organization
Organization Name:BETTER LIFE ADHC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:SUNG HO
Authorized Official - Last Name:CHIN
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:818-780-3900
Mailing Address - Street 1:13550 SHERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-2830
Mailing Address - Country:US
Mailing Address - Phone:818-780-3900
Mailing Address - Fax:818-780-1414
Practice Address - Street 1:13550 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2830
Practice Address - Country:US
Practice Address - Phone:818-780-3900
Practice Address - Fax:818-780-1414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA060000837261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center