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General NPI Number Information
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NPI Number | 1073396123
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Entity Type | Organization
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Legal Business Name | RECOVERY MARRIAGE AND FAMILY COUNSELING INC
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Dates
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Enumeration Date | 08/14/2023
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 9696 CULVER BLVD STE 303
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City | CULVER CITY
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State | CA
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Zip | 90232-2759
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Country | US
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Telephone | 323-723-2674
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Fax |
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Provider Business Mailing Address
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Address Line | 1845 CORINTH AVE APT 101
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City | LOS ANGELES
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State | CA
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Zip | 90025-5573
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Country | US
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Telephone | 425-283-3321
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SIMEON SIMOV
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Credential | LMFT
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Telephone | 425-283-3321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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