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Organization
EXTRAORDINARY OPTIONS
Active
Organization
EXTRAORDINARY OPTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA BROWN (CHAIRMAN)
(310) 721-2411
Entity
Organization
Contact information
Practice address
1776 E CENTURY BLVD, LOS ANGELES, CA 90002-3050
(310) 721-2411
Mailing address
10736 JEFFERSON BLVD., 262, CULVER CITY, CA 90230
(310) 721-2411
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
CA
Other
Enumeration date
02/12/2009
Last updated
02/12/2009
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