Organization
MINERVO
Active
Organization
MINERVO
Active
Other names
Rage Ground
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWIN JAVIER TORIBIO (COO)
(323) 793-3128
Entity
Organization
Contact information
Practice address
1120 1/2 S MAIN ST, LOS ANGELES, CA 90015-2541
(213) 536-5356
Mailing address
1120 1/2 S MAIN ST, LOS ANGELES, CA 90015-2541
(213) 536-5356
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/31/2019
Last updated
01/31/2019
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