# ELDERLY BEHAVIORAL WELLNESS SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871983106
- **Authorized official:** ELENI BAGOURDI (CEO)
- **Authorized official phone:** (310) 999-9683

## Contact information

- **Practice address:** 2001 S BARRINGTON AVE STE 314, LOS ANGELES, CA 90025-5379
- **Practice address phone:** (310) 999-9683
- **Mailing address:** 2001 S BARRINGTON AVE STE 314, LOS ANGELES, CA 90025-5379

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TA0700X | Adult Development & Aging Psychologist | PSY22542 | CA | Yes |

## Other

- **Enumeration date:** 01/26/2015
- **Last updated:** 06/01/2021