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FQHCLA421B TARZANA TREATMENT CENTER, INC. (Active)
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Main Details
Name
TARZANA TREATMENT CENTER, INC.
Subdivision Name
Tarzana Treatment Centers- Antelope Valley Family Medical Clinic
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-031689
340B ID
FQHCLA421B
Grant Number
LALCS40177
Additional Details
Current Program Status
Active
Registration Date
1/28/2021
Participating Start Date
4/1/2021
Participating Approval Date
3/5/2021
Last Recertification Date
2/27/2025
Contacts
Authorizing Official
Tarzana Treatment Centers, Inc.
ALBERT M. SENELLA, PRESIDENT AND CEO
(818) 654-3815
Primary Contact
Tarzana Treatment Centers, Inc.
Wendy De Santiago, Administrative Manager
(818) 654-3815
Addresses
Street Address
907 W Lancaster Blvd
Lancaster, CA 93534-2305
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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May 2025
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