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General NPI Number Information
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NPI Number | 1285236836
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Entity Type | Organization
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Legal Business Name | REVITALIZING MINDS PROJECT
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Dates
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Enumeration Date | 11/09/2020
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Last Update Date | 11/09/2020
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Provider Practice Location Address
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Address Line | 31727 MULHOLLAND HWY
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City | MALIBU
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State | CA
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Zip | 90265-2704
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Country | US
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Telephone | 310-896-5233
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4871
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City | THOUSAND OAKS
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State | CA
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Zip | 91359-1871
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Country | US
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Telephone | 310-896-5233
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ASHLEY J RAMSTEAD
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Credential | LMFT
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Telephone | 310-896-5233
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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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