Organization
ULTIMATE LIFESTYLE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MACHA LISITSA MA, MFT (CEO)
(310) 272-6666
Entity
Organization
Contact information
Practice address
5012 S LA BREA AVE, SUITES # 2-5, LOS ANGELES, CA 90056-1863
(323) 290-0200
(323) 290-0202
Mailing address
5012 S LA BREA AVE, SUITE # 2, LOS ANGELES, CA 90056-1863
(323) 290-0200
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Enumeration date
03/21/2008
Last updated
08/06/2010
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