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General NPI Number Information
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NPI Number | 1912767492
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Entity Type | Organization
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Legal Business Name | VIEW PARK WELLNESS COLLECTIVE, INC
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Dates
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Enumeration Date | 03/20/2024
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Last Update Date | 03/20/2024
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Provider Practice Location Address
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Address Line | 3701 W 54TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90043-2306
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Country | US
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Telephone | 323-717-9436
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Fax | 323-903-5695
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Provider Business Mailing Address
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Address Line | PO BOX 4797
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City | PALOS VERDES PENINSULA
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State | CA
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Zip | 90274-9630
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Country | US
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Telephone | 323-717-9436
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Fax | 323-903-5695
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Authorized Official
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Title or Position | CORPORATE SECRETARY/ DIRECTOR
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Name | MRS. NAOMI MARIE MATHIEU COX
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Credential |
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Telephone | 323-717-9436
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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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