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Organization

ALIVE EDUCATION MANAGEMENT AND SERVICES

Active
Other names
ALIVE EDUCATION MANAGEMENT AND SERVICES
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHANNON NICOLE STANFORD ED.D, BCBA (CEO, CLINICAL DIRECTOR)
(818) 795-5206
Entity
Organization

Contact information

Practice address
152 S LASKY DR STE 208, BEVERLY HILLS, CA 90212-1716
(818) 795-5206
Mailing address
14622 VENTURA BLVD STE 2175, SHERMAN OAKS, CA 91403-3600
(818) 795-5206

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
09/17/2019
Last updated
09/17/2019
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