Premiere Therapy
Community/Behavioral Health in Los Angeles, CA. Organization (NPI-2).
NPI number1962091017
StatusActive
Last updated in NPPESJan 13, 2021
Details
- NPI
- 1962091017
- Entity type
- Organization (NPI-2)
- Legal business name
- Premiere Therapy
- Organization subpart
- No
- Enumeration date
- Jan 13, 2021
- Certification date
- Jan 13, 2021
- Last updated
- Jan 13, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
Other names
- Premiere Therapy (Doing Business As)
- Premiere Events (Former Legal Business Name)
Practice location
1434 S Crescent Heights BlvdLos Angeles, CA 90035-3857
Phone 323-864-9400
Mailing address
1434 S Crescent Heights BlvdLos Angeles, CA 90035-3857
Phone 323-864-9400
Authorized official
Mark Gallo
Coo
3238649400
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