GRAPE STREET COMMUNITY RESTORATION INC. NPI 1619742244

NPI Information

NPI: 1619742244
Provider Name: GRAPE STREET COMMUNITY RESTORATION INC.
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
10139 BEACH ST APT 26A-3
LOS ANGELES, CA
ZIP 90002
Phone: (323) 801-6071
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GRAPE STREET COMMUNITY RESTORATION INC. is a mental health counselor in Los Angeles, CA. GRAPE STREET COMMUNITY RESTORATION INC. NPI is 1619742244. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

10139 BEACH ST APT 26A-3
LOS ANGELES, CA
ZIP 90002-978
Phone: (323) 801-6071

The provider's authorized official is Sebastian Dee Randolph .
The authorized official title is Clinical Mental Health Counselor and has the following contact phone number (602) 736-7383.

The enumeration date for this NPI number is 11/27/2023 and was last updated on 11/27/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101YP2500X	Counselor	Professional	No
2	390200000X	Student in an Organized Health Care Education/Training Program		No
3	101YM0800X	Counselor	Mental Health	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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