Organization
DIVERSIFY BX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN DALENA (CHIEF EXECUTIVE OFFICER)
(562) 900-7481
Entity
Organization
Contact information
Practice address
2601 MARBER AVE, LONG BEACH, CA 90815-1137
(562) 377-1027
Mailing address
2601 MARBER AVE, LONG BEACH, CA 90815-1137
(562) 377-1027
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/23/2021
Last updated
03/05/2021
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