Provider Demographics
NPI:1538237946
Name:CHALLENGER
Entity type:Organization
Organization Name:CHALLENGER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANUPAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSHUA
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:661-940-4025
Mailing Address - Street 1:5300 W AVENUE I
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-8312
Mailing Address - Country:US
Mailing Address - Phone:661-940-4025
Mailing Address - Fax:661-940-4089
Practice Address - Street 1:5300 W AVENUE I
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-8312
Practice Address - Country:US
Practice Address - Phone:661-940-4025
Practice Address - Fax:661-940-4089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC42271320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness