Organization
IGNITE COLLECTIVE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MORGAN DIAS (EXECUTIVE DIRECTOR)
(310) 243-6790
Entity
Organization
Contact information
Practice address
810 LAWRENCE DR STE 100, NEWBURY PARK, CA 91320-6615
(805) 500-6597
Mailing address
16639 CANTLAY ST, VAN NUYS, CA 91406-2806
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
11/27/2023
Last updated
01/12/2024
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