Organization
EYE4PEACE COMMUNITY SERVICES CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY NIBO LCSW (CHIEF OPERATING OFFICER)
(310) 484-4177
Entity
Organization
Contact information
Practice address
11311 HAWTHORNE BLVD UNIT 1, INGLEWOOD, CA 90304-2775
(310) 484-4177
Mailing address
11311 HAWTHORNE BLVD UNIT 1, INGLEWOOD, CA 90304-2775
(310) 484-4177
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/06/2023
Last updated
06/06/2023
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