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General NPI Number Information
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NPI Number | 1083500516
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Entity Type | Organization
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Legal Business Name | TIMELIST GROUP, INC.
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Dates
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Enumeration Date | 06/12/2025
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 311 E AVENUE K4
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City | LANCASTER
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State | CA
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Zip | 93535-4661
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Country | US
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Telephone | 213-544-6220
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Fax |
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Provider Business Mailing Address
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Address Line | 2010 W AVENUE K # 135
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City | LANCASTER
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State | CA
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Zip | 93536-5229
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Country | US
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Telephone | 661-579-0881
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ANDRE LOVELL WILEY
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Credential |
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Telephone | 661-579-0881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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