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Organization
INNOVATIONS COUNSELING SERVICES
Active
Organization
INNOVATIONS COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE C. MCNEAL (CEO)
(323) 326-0860
Entity
Organization
Contact information
Practice address
3756 SANTA ROSALIA DR., SUITE # 617, LOS ANGELES, CA 90008
(323) 326-0860
(323) 296-3332
Mailing address
37744 VINTAGE DR, PALMDALE, CA 93550-7021
(323) 326-0860
(323) 296-3332
Taxonomy
Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
—
NULL
225XM0800X
Mental Health Occupational Therapist
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
NULL
302R00000X
Health Maintenance Organization
Primary
104360CCBCDC
CA
Other
Enumeration date
05/29/2010
Last updated
06/25/2019
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