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General NPI Number Information
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NPI Number | 1164847133
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Entity Type | Organization
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Legal Business Name | NEXT MOVE ANENCY
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Dates
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Enumeration Date | 02/27/2014
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Last Update Date | 02/27/2014
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Provider Practice Location Address
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Address Line | 11270 EXPOSITION BLVD #642931
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City | LOS ANGELES
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State | CA
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Zip | 90064-5903
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Country | US
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Telephone | 310-553-0432
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Fax | 213-402-2101
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Provider Business Mailing Address
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Address Line | 14717 HAWTHORNE BLVD #B
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City | LAWNDALE
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State | CA
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Zip | 90260-1549
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Country | US
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Telephone | 310-553-0432
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Fax | 213-402-2101
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Authorized Official
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Title or Position | OWNER
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Name | DR. BAHBAH MAKOUIE
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Credential |
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Telephone | 310-553-0432
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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 | MFC 52448
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License Number State | CA
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