Organization
LEVANTA COUNSELING SERVICESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEODULO BONZON LCSW (MANAGER)
(818) 846-4469
Entity
Organization
Contact information
Practice address
3013 ANNITA DR, GLENDALE, CA 91206-1302
(818) 846-4469
Mailing address
3013 ANNITA DR, GLENDALE, CA 91206-1302
(818) 846-4469
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
197608981
CA
Other
Enumeration date
11/17/2015
Last updated
11/17/2015
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