| Aj Rich Family Therapy Inc | |
|
2812 Avenel St Los Angeles CA 90039-2047 | |
| (818) 381-9490 | |
| Not Available |
| Full Name | Aj Rich Family Therapy Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2812 Avenel St, Los Angeles, California |
| Authorized Official Name and Position | Alfredo J Fernandez Rich (OWNER) |
| Authorized Official Contact | 8183819490 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aj Rich Family Therapy Inc 2812 Avenel St Los Angeles CA 90039-2047 Ph: (818) 381-9490 | Aj Rich Family Therapy Inc 2812 Avenel St Los Angeles CA 90039-2047 Ph: (818) 381-9490 |
| NPI Number | 1891565982 |
|---|---|
| Provider Enumeration Date | 01/08/2024 |
| Last Update Date | 01/08/2024 |
| Certification Date | 01/08/2024 |
| Medicare PECOS PAC ID | 4284073297 |
|---|---|
| Medicare Enrollment ID | O20240423002528 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891565982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Alfredo J Fernandez Rich |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1649888322 PECOS PAC ID: 5193164101 Enrollment ID: I20240423002673 |
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