Organization
KEY MENTORING
Active
Organization
KEY MENTORING
Active
Other names
Key Mentoring
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN BLIVAS CADAC (COO)
(310) 600-5658
Entity
Organization
Contact information
Practice address
11727 BARRINGTON CT STE 209, LOS ANGELES, CA 90049-6902
(310) 600-5658
Mailing address
11727 BARRINGTON CT STE 209, LOS ANGELES, CA 90049-6902
(800) 421-4364
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
04/16/2018
Last updated
04/16/2018
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