1285494583 NPI number — L&L BEHAVIORAL AND PSYCHIATRIC SERVICES

Table of content: (NPI 1285494583)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285494583 NPI number — L&L BEHAVIORAL AND PSYCHIATRIC SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
L&L BEHAVIORAL AND PSYCHIATRIC SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285494583
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/21/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15005 KILLION ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHERMAN OAKS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91411-3641
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-259-5871
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
414 W TEAGUE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93711-6072
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-789-1245
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/21/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RIMASSA
Authorized Official First Name:
LARA
Authorized Official Middle Name:
VASILJKA
Authorized Official Title or Position:
CEO/FOUNDER
Authorized Official Telephone Number:
985-789-1245

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)