Healthcare Provider Details

I. General information

NPI: 1821993122
Provider Name (Legal Business Name): THINKTANKCOLLECTIVE.INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1028 W 121ST ST
LOS ANGELES CA
90044-2920
US

IV. Provider business mailing address

1028 W 121ST ST
LOS ANGELES CA
90044-2920
US

V. Phone/Fax

Practice location:
  • Phone: 323-632-0950
  • Fax:
Mailing address:
  • Phone: 323-632-0950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. GERNAY MANISH QUINNIE JR.
Title or Position: COMMUNITY HEALTH WORKERS
Credential:
Phone: 323-632-0950