Provider Demographics
NPI:1134574973
Name:EL CENTRO DE AMISTAD, INC
Entity type:Organization
Organization Name:EL CENTRO DE AMISTAD, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INFORMATION SYSTEMS SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINOZA BAIRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-898-0223
Mailing Address - Street 1:8399 TOPANGA CANYON BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304-2354
Mailing Address - Country:US
Mailing Address - Phone:818-347-8565
Mailing Address - Fax:
Practice Address - Street 1:8399 TOPANGA CANYON BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91304-2354
Practice Address - Country:US
Practice Address - Phone:818-347-8565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-29
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health