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General NPI Number Information
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NPI Number | 1932016565
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Entity Type | Organization
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Legal Business Name | SELF DETERMINED FUTURES LLC
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Dates
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Enumeration Date | 08/27/2026
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Last Update Date | 08/27/2026
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Provider Practice Location Address
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Address Line | 18726 S WESTERN AVE STE 415
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City | GARDENA
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State | CA
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Zip | 90248-3858
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Country | US
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Telephone | 562-335-7867
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Fax |
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Provider Business Mailing Address
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Address Line | 18726 S WESTERN AVE STE 415
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City | GARDENA
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State | CA
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Zip | 90248-3858
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Country | US
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Telephone | 562-335-7867
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | EBONY MONTGOMERY
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Credential | MBA
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Telephone | 562-335-7867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 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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Taxonomy #3
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Taxonomy Code | 261QP2400X
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Taxonomy Name | Prison Health Clinic/Center
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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 | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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