| Mindful Living Center California Llc | |
|
714 W Olympic Blvd Ste 614 Los Angeles CA 90015-1485 | |
| (213) 510-6150 | |
| Not Available |
| Full Name | Mindful Living Center California Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 714 W Olympic Blvd Ste 614, Los Angeles, California |
| Authorized Official Name and Position | Luke Tharasri (MANAGER) |
| Authorized Official Contact | 3234193869 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Living Center California Llc 900 Pacific Coast Hwy Apt 105 Huntington Beach CA 92648-4859 Ph: (323) 419-3869 | Mindful Living Center California Llc 714 W Olympic Blvd Ste 614 Los Angeles CA 90015-1485 Ph: (213) 510-6150 |
| NPI Number | 1275124737 |
|---|---|
| Provider Enumeration Date | 01/28/2021 |
| Last Update Date | 06/29/2023 |
| Certification Date | 06/29/2023 |
| Medicare PECOS PAC ID | 0648689216 |
|---|---|
| Medicare Enrollment ID | O20210511002825 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275124737 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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