Organization
AMERICAN INDIAN CHANGING SPIRITS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE LEVAN MPH, CCEP, CHC (CHIEF COMPLIANCE OFFICER)
(310) 679-9126
Entity
Organization
Contact information
Practice address
2120 W WILLIAMS ST BLDG 3, LONG BEACH, CA 90810-3636
(562) 388-8118
(562) 388-8117
Mailing address
15519 CRENSHAW BLVD, GARDENA, CA 90249-4525
(310) 679-9126
(310) 679-2920
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190239AN
CA
Other
Enumeration date
06/08/2018
Last updated
06/08/2018
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