| The Treasure Grid | |
|
725 S Alvarado St Apt 301 Los Angeles CA 90057-4313 | |
| (323) 635-0173 | |
| Not Available |
| Full Name | The Treasure Grid |
|---|---|
| Speciality | Counselor |
| Location | 725 S Alvarado St Apt 301, Los Angeles, California |
| Authorized Official Name and Position | Kerry Bryant Lewis (CEO) |
| Authorized Official Contact | 3239556253 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Treasure Grid 725 S Alvarado St Apt 301 Los Angeles CA 90057-4313 Ph: (323) 635-0173 | The Treasure Grid 725 S Alvarado St Apt 301 Los Angeles CA 90057-4313 Ph: (323) 635-0173 |
| NPI Number | 1720659709 |
|---|---|
| Provider Enumeration Date | 07/09/2021 |
| Last Update Date | 09/19/2024 |
| Certification Date | 09/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720659709 | NPI | - | NPPES |
| 95444626G80154 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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