Organization
THE LIFE CHARM INC
Active
Other names
SOLUNA WELLNESS
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER PENROD (BILLER)
(305) 900-4715
Entity
Organization
Contact information
Practice address
1419 UNIVERSITY AVE, SAN DIEGO, CA 92103-3459
(619) 876-4015
(619) 883-9360
Mailing address
6231 VISTA SAN CARLOS, SAN DIEGO, CA 92154-5607
(619) 876-4015
(619) 883-9360
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/13/2021
Last updated
03/13/2023
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