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Organization Active NPI

Tarzana Treatment Centers, Inc.

  • Substance Abuse Rehabilitation Facility
  • Long Beach, CA
National Provider Identifier
1003941683
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
190085NN Issued in CA
Legal business name
TARZANA TREATMENT CENTERS, INC.
Practice address
5190 Atlantic Ave
Long Beach, CA 90805-6510
Phone
(818) 996-1051
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Albert Senella
Title
President/ Chief Executive Officer
Phone
(818) 654-3815

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171M00000X
Supports Brokerage Agency 251X00000X
Multi-Specialty Clinic/Center 261QM1300X
Substance Abuse Rehabilitation Facility 324500000X 190085NN CA Primary
Clinic Pharmacy 3336C0002X

Addresses

Primary practice location

5190 Atlantic Ave
Long Beach, CA 90805-6510

Mailing address

18646 Oxnard St
Tarzana, CA 91356-1411
Phone (818) 996-1051

Other identifiers 1

IdentifierTypeStateIssuer
054148OtherCANPPES OSCAR CORRECTION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA3 enrollments
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20070822001488 CA Part B Supplier - Clinic/Group Practice 5991897845 Receives reassigned benefits from 100 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tarzana, CA; Woodland Hills, CA; Reseda, CA; Palmdale, CA; Los Angeles, CA; Northridge, CA; Lancaster, CA; Long Beach, CA
O20200306000778 CA Part B Supplier - Opioid Treatment Program (Otp) 5991897845 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Long Beach, CA; Palmdale, CA; Tarzana, CA
O20210907003266 CA Part A Provider - Federally Qualified Health Center (FQHC) 5991897845 Practice locations: Long Beach, CA

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Federally qualified health center certification: CCN A01020

Legal name
TARZANA TREATMENT CENTERS INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 11, 2021
Last certification
Aug 11, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 15, 1972 in CA
Enrollment address
5190 Atlantic Ave
Long Beach, CA 90805-6510

National Provider Directory

National Provider Directory

Locations

18700 Oxnard St
Tarzana, CA 91356
Phone (818) 654-3950

Ownership & related parties

All disclosed owners & managing parties 21

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kenneth Bachrach Individual Operational/Managerial ControlClinical Director Jun 10, 1987
Antionette Olivarez Individual Operational/Managerial ControlDirector of Nursing Sep 6, 2006
Keith Ian Star Individual Operational/Managerial ControlDirector of Detox & Inpatient Jan 31, 2005
Stanley Galperson Individual Operational/Managerial ControlDirector of Residential Jan 8, 1996
Alesia Ping-Difiore Individual Operational/Managerial ControlDirector of Antelope Valley Sep 1, 2006
Jim Sorg Individual Operational/Managerial ControlDirector of Integrated Care Aug 1, 2000
Michael Sheptenko Individual Corporate Director Jul 1, 2009
Nora Monica Kirshberg Individual Corporate Director Jul 1, 2019
Ronald Kurstin Individual Corporate Director Jul 1, 2002
Anne Greenberg Individual Corporate Director Jul 1, 2019
Silvia Cadena Individual Corporate OfficerChief Financial Officer Aug 1, 1988
Albert Senella Individual Corporate OfficerPresident/Chief Executive Officer Aug 1, 1998
Operational/Managerial ControlPresident/Chief Executive Officer Aug 1, 1998 100%
Rudolph Omurray Individual Operational/Managerial ControlDirector of Primary Care Mar 1, 2017
Tarzana Treatment Centers Inc Organization, Tarzana, CA Non-profit Operational/Managerial Control Aug 1, 1998 100%
Lauren Dibbs Individual Operational/Managerial ControlDirector of Long Beach Apr 25, 2008
Jose Salazar Individual Operational/Managerial ControlDirector of Program Development Oct 31, 2001
Andrew Kirshberg Individual Corporate Director Jul 1, 2019
VA Lecia Adams Individual Corporate Director Jul 1, 2019
Richard Helfman Individual Corporate DirectorBoard Chairperson Jul 1, 2019
Patrick Ogawa Individual Corporate Director Jul 1, 2019
Linda Farris-Vogel Individual Corporate Director Jul 1, 2019

Owners & managing parties with NPI records 10

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Tarzana Treatment Centers IncTarzana, CA, CCN 054148 Hospital Operational/Managerial Control (100%) Aug 15, 1972
Tarzana Treatment Centers IncLancaster, CA, CCN 921920 Federally qualified health center Operational/Managerial Control (100%) Aug 1, 1998
Tarzana Treatment Centers IncTarzana, CA, CCN 921948 Federally qualified health center Operational/Managerial Control (100%) Aug 1, 1998
Tarzana Treatment Centers IncPalmdale, CA, CCN 921922 Federally qualified health center Operational/Managerial Control (100%) Aug 1, 1998
Tarzana Treatment Centers IncNorthridge, CA, CCN 921921 Federally qualified health center Operational/Managerial Control (100%) Aug 1, 1998
Tarzana Treatment Centers IncReseda, CA, CCN 921947 Federally qualified health center Operational/Managerial Control (100%) Aug 1, 1998
Tarzana Treatment Centers IncReseda, CA, CCN A11012 Federally qualified health center Operational/Managerial Control (100%) Aug 1, 1998
Tarzana Treatment Centers IncPalmdale, CA, CCN A01971 Federally qualified health center Operational/Managerial Control (100%) Aug 1, 1998

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 8

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Other NPIs on the same Medicare enrollment 21

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 21

Practitioners 60

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 60

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644192000000",
    "number": "1003941683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18646 OXNARD ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913561411",
            "telephone_number": "818-996-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5190 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908056510",
            "telephone_number": "818-996-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARZANA TREATMENT CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A",
        "authorized_official_last_name": "SENELLA",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "PRESIDENT/ CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "818-654-3815"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190085NN",
            "primary": true
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES OSCAR CORRECTION",
            "identifier": "054148",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.