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General NPI Number Information
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NPI Number | 1477003119
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Entity Type | Organization
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Legal Business Name | INSIGHT HEALTH AND WELLNESS, LLC
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Dates
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Enumeration Date | 10/05/2016
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Last Update Date | 01/06/2021
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Provider Practice Location Address
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Address Line | 2211 CORINTH AVE STE 103
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City | LOS ANGELES
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State | CA
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Zip | 90064-1620
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Country | US
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Telephone | 310-456-8451
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Fax | 888-891-2295
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Provider Business Mailing Address
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Address Line | 2211 CORINTH AVE STE 103
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City | LOS ANGELES
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State | CA
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Zip | 90064-1620
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Country | US
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Telephone | 310-456-8451
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Fax | 888-891-2295
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. MELINDA GEREMILLO DRAKE
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Credential | LCSW
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Telephone | 424-781-7306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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