Organization
CR8TIVE MINDZ
Active
Organization
CR8TIVE MINDZ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KANDICE GRAY (CEO/CO-FOUNDER, LCSW)
(310) 654-7485
Entity
Organization
Contact information
Practice address
1777 N BELLFLOWER BLVD STE 105, LONG BEACH, CA 90815-4019
(323) 402-1803
Mailing address
556 W 3RD ST, SAN PEDRO, CA 90731-2506
(323) 402-1803
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
251V00000X
Voluntary or Charitable Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
09/01/2022
Last updated
09/01/2022
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