Healthcare Provider Details

I. General information

NPI: 1164216487
Provider Name (Legal Business Name): MAKE IT HAPPEN CONGLOMERATE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 04/09/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2081 W MAIN ST STE 103
BARSTOW CA
92311
US

IV. Provider business mailing address

PO BOX 347
BARSTOW CA
92312
US

V. Phone/Fax

Practice location:
  • Phone: 442-295-9096
  • Fax:
Mailing address:
  • Phone: 760-979-7938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: CHARMILL DORMETRA VEGA
Title or Position: FOUNDER/CEO
Credential: LMFT
Phone: 760-979-7938