Organization
LAT MENTAL HEALTH MANAGEMENT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDY PISKOULIAN (PRESIDENT)
(310) 552-8646
Entity
Organization
Contact information
Practice address
11936 JEFFERSON BLVD STE B, CULVER CITY, CA 90230-6333
(310) 572-7000
Mailing address
11936 JEFFERSON BLVD, SUITE B, CULVER CITY, CA 90230-6333
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251B00000X
Case Management Agency
—
CA
251E00000X
Home Health Agency
—
CA
251J00000X
Nursing Care Agency
—
CA
251S00000X
Community/Behavioral Health Agency
—
CA
253Z00000X
In Home Supportive Care Agency
—
CA
261Q00000X
Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
273R00000X
Psychiatric Hospital Unit
—
—
314000000X
Skilled Nursing Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
06/27/2013
Last updated
06/26/2014
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