Organization
CREATE REALISTIC CHANGE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CALIFIA ABWOON RECOVERY PRACTIONER (FOUNDER AND DIRECTOR)
(424) 222-1795
Entity
Organization
Contact information
Practice address
1873 W 54TH ST, LOS ANGELES, CA 90062-2604
(424) 222-1795
Mailing address
531 MAIN ST STE 1132, EL SEGUNDO, CA 90245-3060
(424) 222-1795
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
—
225400000X
Rehabilitation Practitioner
—
—
251B00000X
Case Management Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
12/07/2018
Last updated
10/21/2019
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