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General NPI Number Information
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NPI Number | 1306295597
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Entity Type | Organization
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Legal Business Name | 4 MISSING PEACE CORP., INC.
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Dates
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Enumeration Date | 06/08/2016
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Last Update Date | 08/13/2019
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Provider Practice Location Address
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Address Line | 30101 AGOURA CT STE 150
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City | AGOURA HILLS
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State | CA
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Zip | 91301
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Country | US
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Telephone | 818-874-3071
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Fax |
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Provider Business Mailing Address
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Address Line | 30101 AGOURA CT STE 150
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City | AGOURA HILLS
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State | CA
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Zip | 91301-4369
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Country | US
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Telephone | 818-874-3071
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER/THERAPIST
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Name | MRS. LAURA RHODES-LEVIN
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Credential | LMFT
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Telephone | 323-898-1988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 96187
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License Number State | CA
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Taxonomy #2
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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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