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Organization
SOLACE MENTAL HEALTH THERAPY, INC.
Active
Organization
SOLACE MENTAL HEALTH THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANI IFIKTCHYAN LCSW (PRESIDENT)
(818) 669-2037
Entity
Organization
Contact information
Practice address
500 E OLIVE AVE STE 720, BURBANK, CA 91501-2132
(747) 333-8559
Mailing address
500 E OLIVE AVE STE 720, BURBANK, CA 91501-2132
(747) 333-8559
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649792722
OPTUM, ANTHEM
CA
Enumeration date
04/28/2022
Last updated
04/28/2022
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