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Organization

DEVELOP ACHIEVE SUCCEED

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DIVINITY SARDIN LCSW (MANAGER/OWNER)
(562) 965-6782
Entity
Organization

Contact information

Practice address
1225 W 190TH ST # 455G, GARDENA, CA 90248-4320
(562) 965-6782
Mailing address
9835 FLOWER ST UNIT 1523, BELLFLOWER, CA 90707-7074
(562) 965-6782

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
12/30/2021
Last updated
12/30/2021
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