MEDICARE: MELI MUSIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101200000X	Drama Therapist
2	101YP2500X	Professional Counselor
3	104100000X	Social Worker
4	1041C0700X	Clinical Social Worker
5	221700000X	Art Therapist
6	225600000X	Dance Therapist
7	225A00000X	Music Therapist

General Provider Information

NPI Number	:	1104462779
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MELI MUSIC LLC

Provider Business Mailing Address
First Line	:	PO BOX 56015
Second Line	:
City	:	HARWOOD HEIGHTS
State	:	IL
Zip	:	60656-0922
Country	:	US
Telephone Number	:	818-394-0649
Fax Number	:

Provider Business Practice Location Address
First Line	:	16133 VENTURA BLVD FL 7
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91436-2403
Country	:	US
Telephone Number	:	747-777-0451
Fax Number	:	747-777-0451

Authorized Official
Title or Position	:	OWNER
Name	:	MELISSA SOMMERS
Credential	:
Telephone Number	:	747-777-0451

Provider Enumeration Date	:	11/19/2019
Last Update Date	:	05/10/2021

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Directions to “MELI MUSIC LLC ” Practice Location

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