Organization
HEADSPACE MEDICAL GROUP (KS) LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRINA SHTEMLER (NETWORK OPERATIONS MANAGER)
(855) 446-4374
Entity
Organization
Contact information
Practice address
2417 MICHIGAN AVE, SANTA MONICA, CA 90404-4009
(855) 446-4374
Mailing address
2417 MICHIGAN AVE, SANTA MONICA, CA 90404-4009
(855) 446-4374
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/29/2025
Last updated
10/29/2025
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