| La Raiz Behavioral Solutions | |
|
5239 Harmony Ave Apt 306 N Hollywood CA 91601-5536 | |
| (818) 749-2263 | |
| Not Available |
| Full Name | La Raiz Behavioral Solutions |
|---|---|
| Speciality | Behavior Analyst |
| Location | 5239 Harmony Ave Apt 306, N Hollywood, California |
| Authorized Official Name and Position | Jose Rios (OWNER) |
| Authorized Official Contact | 8187492263 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| La Raiz Behavioral Solutions 1812 W Burbank Blvd # 7003 Burbank CA 91506-1315 Ph: (818) 749-2263 | La Raiz Behavioral Solutions 5239 Harmony Ave Apt 306 N Hollywood CA 91601-5536 Ph: (818) 749-2263 |
| NPI Number | 1114663515 |
|---|---|
| Provider Enumeration Date | 05/09/2022 |
| Last Update Date | 05/17/2022 |
| Certification Date | 05/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114663515 | NPI | - | NPPES |
| 1124584602 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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