1801264122 NPI number — TIME 4 ME - COUNSELING & CONSULTING, INC.

Table of content: (NPI 1801264122)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801264122 NPI number — TIME 4 ME - COUNSELING & CONSULTING, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TIME 4 ME - COUNSELING & CONSULTING, INC.
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:
6
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:
1801264122
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/03/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1726
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONROVIA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91017-5726
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-955-5531
Provider Business Mailing Address Fax Number:
626-359-8887

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
37 AUBURN AVE STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SIERRA MADRE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91024-1846
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-955-5531
Provider Business Practice Location Address Fax Number:
626-359-8887
Provider Enumeration Date:
09/02/2015

Additional Information

Authorized Official

Authorized Official Last Name:
SINGLETON
Authorized Official First Name:
LISHA
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
972-955-5531

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  31151 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 173705801 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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