Healthcare Provider Details

I. General information

NPI: 1215779285
Provider Name (Legal Business Name): SERVANT-LEADERS OF THE WORLD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2024
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 S CEDAR ST
GLENDALE CA
91205-1207
US

IV. Provider business mailing address

3949 LOS FELIZ BLVD APT 510
LOS ANGELES CA
90027-2323
US

V. Phone/Fax

Practice location:
  • Phone: 323-868-5252
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: LUCINA BABAYANTS
Title or Position: LMFT/OWNER
Credential:
Phone: 323-868-5252