Provider Demographics
NPI:1881080216
Name:THE TEEN PROJECT, INC.
Entity type:Organization
Organization Name:THE TEEN PROJECT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURI
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-283-1260
Mailing Address - Street 1:8140 SUNLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-3948
Mailing Address - Country:US
Mailing Address - Phone:800-685-7460
Mailing Address - Fax:818-582-8836
Practice Address - Street 1:14530 SYLVAN ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-2324
Practice Address - Country:US
Practice Address - Phone:818-582-8832
Practice Address - Fax:818-582-8836
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE TEEN PROJECT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-04-13
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190811AN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility