Organization
GRAMERCY THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER TAYLOR LMFT (OWNER)
(310) 985-1022
Entity
Organization
Contact information
Practice address
300 S GRAMERCY PL APT 110, LOS ANGELES, CA 90020-4537
(310) 985-1022
Mailing address
300 S GRAMERCY PL APT 110, LOS ANGELES, CA 90020-4537
(310) 985-1022
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629460720
NPI
CA
01
—
4999941
MEDICAL
CA
01
—
601066713
MAGELLAN
CA
Enumeration date
03/11/2021
Last updated
03/11/2021
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