Provider Demographics
NPI:1740724707
Name:TRUECARE BEHAVIORAL HEALTH CENTER, INC.
Entity type:Organization
Organization Name:TRUECARE BEHAVIORAL HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FANTONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-992-3121
Mailing Address - Street 1:6303 OWENSMOUTH AVE FL 10
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-2262
Mailing Address - Country:US
Mailing Address - Phone:818-992-3121
Mailing Address - Fax:888-959-5641
Practice Address - Street 1:6303 OWENSMOUTH AVE FL 10
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-2262
Practice Address - Country:US
Practice Address - Phone:818-992-3121
Practice Address - Fax:888-959-5641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-11
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACS332AMedicare UPIN