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General NPI Number Information
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NPI Number | 1194134007
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Entity Type | Organization
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Legal Business Name | MOTIVATIONAL RECOVERY SERVICES
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Dates
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Enumeration Date | 08/05/2014
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Last Update Date | 08/05/2014
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Provider Practice Location Address
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Address Line | 8561 SANTA FE AVE.
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City | HUNTINGTON PARK
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State | CA
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Zip | 90265
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Country | US
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Telephone | 818-848-9995
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Fax |
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Provider Business Mailing Address
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Address Line | 8561 SANTA FE AVE
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-6715
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | JENNYFHER ESTELA OLIVARES
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Credential |
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Telephone | 818-266-6959
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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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