| Organization Name: | LAS VIRGENES BIHAVIORAL HEALTH AND MEDICAL CLINIC, INC |
| NPI Number: | 1720283096 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | IRINA CHMELEVA (BILLER) |
| Mailing Address: | 30101 Agoura Ct Ste 212 Agoura Hills |
| State: | CA US |
| Postal Code: | 913014372 |
| Phone Number: | 8188799018 |
| Fax Number: | 8188799013 |
| NPI Enumeration Date: | 06/18/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2084A0401X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Psychiatry & Neurology |
| Taxonomy Specialization: | Addiction Medicine |
| Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |