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Organization
CREATE REALISTIC CHANGE INC
Active
Organization
CREATE REALISTIC CHANGE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CALIFIA ABWOON RECOVERY PRACTIONER (FOUNDER AND DIRECTOR)
(424) 222-1795
Entity
Organization
Contact information
Practice address
1873 W 54TH ST, LOS ANGELES, CA 90062-2604
(424) 222-1795
Mailing address
531 MAIN ST STE 1132, EL SEGUNDO, CA 90245-3060
(424) 222-1795
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
NULL
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
NULL
171M00000X
Case Manager/Care Coordinator
—
—
225400000X
Rehabilitation Practitioner
—
NULL
225400000X
Rehabilitation Practitioner
—
—
251B00000X
Case Management Agency
—
NULL
251V00000X
Voluntary or Charitable Agency
—
NULL
261QR0400X
Rehabilitation Clinic/Center
Primary
—
NULL
Other
Enumeration date
12/07/2018
Last updated
10/21/2019
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