Organization
LIFE UNCOMMON, LLC
Active
Organization
LIFE UNCOMMON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CORRIE L GREATHOUSE (CHIEF EXECUTIVE OFFICER)
(310) 356-9951
Entity
Organization
Contact information
Practice address
8616 LA TIJERA BLVD, SUITE 404, LOS ANGELES, CA 90045-3944
(310) 356-9951
Mailing address
8616 LA TIJERA BLVD, SUITE 404, LOS ANGELES, CA 90045-3944
(310) 356-9951
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
08/29/2015
Last updated
10/13/2015
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