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FQHCLA421E TARZANA TREATMENT CENTER, INC. (Active)
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Main Details
Name
TARZANA TREATMENT CENTER, INC.
Subdivision Name
Tarzana Treatment Centers - Atlantic Ave
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-032159
340B ID
FQHCLA421E
Grant Number
LALCS40177
Additional Details
Current Program Status
Active
Registration Date
4/13/2021
Participating Start Date
4/19/2021
Participating Approval Date
4/19/2021
Last Recertification Date
2/11/2025
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
5190 Atlantic Ave
Long Beach, CA 90805-6510
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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