NPIMap

Organization Active NPI

Tarzana Treatment Centers, Inc.

  • Multi-Specialty Clinic/Center
  • Lancaster, CA
National Provider Identifier
1639390339
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
TARZANA TREATMENT CENTERS, INC.
Practice address
907 W Lancaster Blvd
Lancaster, CA 93534-2305
Phone
(661) 723-4829
NPI assigned
May 1, 2007
Last updated
Dec 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Authorized official

Name
Jim Sorg
Title
Director of It
Phone
(818) 654-3911

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

907 W Lancaster Blvd
Lancaster, CA 93534-2305

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

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

Other NPIs on the same Medicare enrollment 21

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

View all 21

National Provider Directory

National Provider Directory

Locations

907 W Lancaster Blvd
Lancaster, CA 93534
Phone (661) 723-4829

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608595200000",
    "number": "1639390339",
    "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": "91356",
            "telephone_number": "818-996-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 W LANCASTER BLVD",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342305",
            "telephone_number": "661-723-4829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARZANA TREATMENT CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A",
        "authorized_official_last_name": "SORG",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "DIRECTOR OF IT",
        "authorized_official_telephone_number": "818-654-3911"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.