MEDICARE: INVICTA THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1194358978
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INVICTA THERAPY

Provider Business Mailing Address
First Line	:	2235 LAKE AVE STE 110
Second Line	:
City	:	ALTADENA
State	:	CA
Zip	:	91001-6002
Country	:	US
Telephone Number	:	626-786-4864
Fax Number	:

Provider Business Practice Location Address
First Line	:	2235 LAKE AVE STE 110
Second Line	:
City	:	ALTADENA
State	:	CA
Zip	:	91001-6002
Country	:	US
Telephone Number	:	626-786-4864
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ARMAN TER-GRIGORYAN
Credential	:	LMFT
Telephone Number	:	626-786-4864

Provider Enumeration Date	:	02/19/2020
Last Update Date	:	03/28/2022

Similar Medicare Providers

1285949511 — ARMAN TER-GRIGORYAN LMFT
Practice Location Address:

2235 LAKE AVE STE 110
ALTADENA, CA
91001-6002

Practice Phone: 626-786-4864
Practice Fax: 626-569-7046

1043153240 — NARINE KELESHYAN
Practice Location Address:

2073 MINORU DR
ALTADENA, CA
91001-3417

Practice Phone: 818-590-3101
Practice Fax:

1578698825 — MRS. DONCELLA MUMOLO LMFT
Practice Location Address:

760 MOUNTAIN VIEW ST
ALTADENA, CA
91001-4925

Practice Phone: 626-798-6793
Practice Fax: 626-585-1664

1992703763 — DR. DAVID STUART CAMPBELL D.D.S.
Practice Location Address:

1955 LAKE AVE
ALTADENA, CA
91001-3037

Practice Phone: 626-585-9544
Practice Fax: 626-449-4932

1194724070 — DR. CAMPBELL DDS, INC.
Practice Location Address:

1955 LAKE AVE
ALTADENA, CA
91001-3037

Practice Phone: 626-585-9544
Practice Fax: 626-449-4932

1992798847 — COMPASSIONATE CARE HOME HEALTH, INC.
Practice Location Address:

2235 N LAKE AVE , SUITE 209
ALTADENA, CA
91001-2465

Practice Phone: 626-791-3300
Practice Fax: 626-791-5502

Directions to “INVICTA THERAPY ” Practice Location

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